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Dentistry/should i get onlay or implant

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Question
I had a gold onlay bridge that lasted 10 yrs. The span covered 18-20. #18 separated and the gold popped out. #20 is holding the pontic in place. My dentist (he didn't originally place it) said the onlay probably separated because the gold was too soft, and that more palladium should have been used. How long should a  gold onlay bridge like mine lasted?
My dentist gave me 2 choices-new onlay with more palladium or implant for #19, fill the hole in #18 with composite, and keep the gold in #20. He favors the implant route because he thinks it's more conservative. But I think since the hole already exists in #18, and he can easily remove the gold from #20, that making a new bridge shouldn't require much drilling. What choice would you make? Will an implant give a better facial appearance than a bridge?
I must point out that I had an extraction of #16, and #15 will likely be too. I have a severe furcation near #15, so an implant there is probably out of the question. Should extractions of #16 and #15 weigh in my decision to get an implant for #19?

Answer
Get the implant it is more long lasting.You did better than average on the lifespan for a bridge.As long as 14 is intact and in function 15 16 have no bearing on 19.I don't buy the soft gold rap.I've seen gold restorations that lasted 50 years.Get the implant.

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Rafael Mosery,D.D.S.

Expertise

I`m a practicing general dentist for 29 years. Member of ADA,NYSDA,SDDS. In addition I am a fellow of the ICOI.My emphasis is on Implant Dentistry .I would be happy to answer questions regarding implant dentistry as well as general dental questions. Ofcourse within the limitations of no clinical exam and the absence of radiographs .

Experience

Private practice for 29 years. Have kept up to date with continuing education throughout that time.




Organizations
ADA,NYDSA,SDDS,ICOI fellow,Penninsula Hospital Dental Society

Education/Credentials
NYU College of Dentistry DDS 1984 NYU College of Dentistry Surgical and prosthetic implantology program 1999-2001

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