Missing a front tooth is the thing of nightmares! A study done by Yu in 2012 showed that 39% of the population have had a dream about losing a tooth or teeth which is huge considering losing a front tooth is not a particularly common dental issue. However, accidents happen and in our case study our patient lost his front tooth whilst at school in a playground accident.
What Are The Options For Replacing A Missing Front Tooth?
In most cases, the options will be:
1. An Immediate Removable Denture
This would be an acrylic plate to replace the tooth with the big advantage that it can usually be made within 24 hours. Being removable, this is ideal in an emergency to allow the area to heal fully before deciding on a more long term approach. As the area does heal, the gum line will change will means that the immediate denture will not fit very well after a few weeks. Hence this is a short term solution only and we would never recommend a removable denture as a long term solution for someone in their late teens as in our case to follow.
2. A Fixed Bridge
Years ago, this probably would have been the first choice option. The adjacent tooth or teeth would have to be drilled down ( yes, drilled!) to create space for the bridge to be placed on the supporting tooth/teeth and replace the missing tooth. Although this is a fixed option, it is very destructive especially if there is nothing wrong with the adjacent teeth. Studies have shown that there is a risk of the prepared tooth needing a root canal treatment later down the line in the region of 17-20%, which is very high. Hence, we would not be keen to advise a fixed bridge in a young person.
3. An Adhesive Bridge
With the advent of adhesive dentistry, we can use techniques which allow us to use to simply glue a new tooth in place on the back of the adjacent tooth. The huge advantage of this is that it is a minimally invasive technique and requires little , if any, preparation of the adjacent tooth. The disadvantage is that we are dealing with glue and glue can fail! This would mean the tooth simply comes off , not ideal but no harm done. This is the option we chose in our case.
4. A Dental Implant
This would be considered the gold standard to replace a missing tooth in an adult. However, for someone in their late teens, there is plenty of evidence to show that growth can still occur into the twenties hence placing implants at such an early age would not be a wise idea. The reason being that implants 'fuse' to the surrounding bone and if there is still growth of the jaws, the position of that implant could be very different in a few years which would have a detrimental impact on the aesthetics of a front tooth.
Our Case Study: Using A Zirconia Bridge
As mentioned earlier, our patient lost his front tooth in a playground accident which was immediately restored with a denture and then an adhesive bridge. After a few years, he wanted something more aesthetic as the bridge was not looking great.
Missing his left front tooth. What a nightmare!
We made the decision in the end to use a zirconia bridge which is all ceramic. The alternative was to use a metal wing but for aesthetics , using all ceramic is far superior as the grey shadow of the metal is not an issue. This is how it now looks:
Wow. What a stunning result. Life like, natural and minimally invasive.
The bridge is simply glued on to the inside surface of the adjacent tooth. There are , of course, certain requirements that are needed and various other factors that we clinically need. This is all in the planning and communication between the dentist and the laboratory. Here is how the tooth looks on the inside:
No metal present. Zirconia tooth and zirconia wing. Treatment completed by Dr Nissit Patel.
Have A Tooth Gap That Needs Filling?
If you or a friend/ loved one has a gap that needs filling, we can help and will have more than just one solution. Please contact us and we will arrange a free video consultation or an appointment to replace your missing tooth with confidence.
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