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Dentistry/is it ok to treat adjacent tooth of a recent implant


Thanks very much for your prior advice. I had an implant last week on 19 and now want to get hole from failed onlay bridge (18) worked on. (20 gold onlay remained intact after pontic was severed by oral surgeon prior to implant.) You suggested a new onlay (gold, I assume.) I don't know why prosthodontist is favoring composite over an onlay or crown. (Perhaps, he thinks it is still doable with composite.) I have cusps on both sides of this tooth, do these cusps change the situation so composite  is preferred? I think it is still a large hole. Should I request an onlay or crown?
The first week in Jan I will have an appt. for tooth 18. If I get an onlay or crown won't an impression (old-fashioned style that you bite down on tray) put pressure on the implant? Is it too soon to begin work? Also, my oral surgeon recommended I get a flipper to prevent teeth shifting. Can teeth shift a great deal during 4 months?

Dear Michael,

Either a crown or an onlay is indicated for a tooth when more than 2/3 of its volume is filling or decay or a combination of both filling and decay.  If an onlay is indicated for tooth #20, a back tooth which is considered to be in the "esthetic zone", I would use a product called Lava Ultimate.  It is referred to as a ceramic due to its high glass content.  But it is, in reality, a composite material that is manufactured by 3M corp using heat, vacuum and light, into blocks to be used in cad-cam milling machines.  This is relatively new technology, but 3M provides a 10-year warranty against fracture or wear-thru.  I would recommend this for your #20 onlay.

First measure the distance between the cusp tips on either side of the tooth, then measure the width of the filling between those cusps. If the width of the filling is greater than 2/3 of the width between the cusp tips, this tooth should be treated to either a crown or an onlay.

If an impression is needed, it will not adversely effect the implant.  It is not too soon to treat 20.  It may be too soon for 18.  Teeth can shift a great deal in 4 months.


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Howard Finnk, D.D.S., P.A., CEO


I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.


Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center ( On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (, I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

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Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

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