Expert: Mark Bornfeld DDS - 10/31/2007

Question
Dear Doctor,

I had a bridge with the following conditions:

1- Its spanning over teeth 3,4,5 and 6 of the upper jaw. 3 and 6 are the abutments.
2- The abutments are covered with titanium/porcelain caps
3-The final cementing of the bridge was April 2007.
4-Tooth 5 was extracted shortly before the bridge installation.

Less than a week ago, I start feeling a micro movement regarding the abutment/cap of tooth 6. I can't tell if the  abutment/cap are moving together or just the cap due to cementing failure. How can I be sure without causing further damage especially to the other abutment/cap of Tooth 3. I do not feel or notice any sensitivity of the cap/abutment of tooth 6.
Would it be advisable to leave it since the other abutment is stronger and holding the bridge. I am afraid if I go and see a dentist the damage will be increased and the cost will be high.


Answer
Dear LUAY,

I would advise you against ignoring this problem. Even if tooth #3 is strong enough to support the bridge on its own (which is doubtful), tooth #6 will begin to decay under the abutment crown if the cement has washed out and the crown has broken free. It is also likely that since a substantial amount of the task of supporting the bridge has now by default fallen on tooth #3, that it will suffer from the excessive stresses it now will incur. The resulting damage will be far more costly to correct, in terms of time, money, and effort.

I recommend that you return to your dentist. He will probably attempt to remove the fixed bridge and re-cement it-- if possible, with a stronger resin-based luting cement that will better resist wash-out so that this type of event doesn't recur.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY