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Oral Surgery/will my facial appearance look better with implant than with onlay

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QUESTION: Is there a difference in facial appearance whether a pontic is used (as part of a gold onlay bridge) or if an implant is used? #19 was extracted 10 yrs. ago, and I had a gold onlay bridge made at the time. This bridge recently broke, and I want to know for facial appearance, should I get the implant instead of a new bridge?
It should be noted that #16 was extracted and #15 will likely be too. I think because of a severe furcation, an implant won't be possible in the space of #15. Should extractions of #16 and #15 weigh in my decision to get an implant for #19? Can three extractions on the left side of my face cause it to look distorted? And this won't be corrected by the pontic, but only by the implant in #19?

ANSWER: Hi Mike,

There is no difference in facial profile when you get an implant or a bridge. On the maxillary area, you could have a sinus lift procedure and get an implant. I prefer you get an implant on the lower jaw as well. They are more natural and easier to clean when compared to a bridge.

---------- FOLLOW-UP ----------

QUESTION: I decided on the implant. The oral surgeon's office gave me a consent form that stated, "if an implant is placed in the lower jaw, there may be some tingling or numbness on the skin, or the lip, chin, cheek, tongue or gum after the surgery. This can occur from pressure or compression of the nerve tract. If there is bruising in this area, either during or after the surgical procedures, it is possible that this numbness may occur. This tingling or numbness is usually temporary, but it may remain for weeks or months. In rare cases, the numbness, loss of sensation, or altered sensation may be permanent."
Here are my questions:
Doesn't bruising occur in all cases because of the initial incision to place the implant?
Isn't pressure or compression placed on the nerve tract when any implant is done on the lower jaw?
What percent of patients who have an implant in the lower jaw will end up with tingling or numbness that lasts for weeks or months?
What percent is there permanent damage to the nerve?
Thanks again!

Answer
These are excellent questions that should have been discussed during the consultation. Some bruising may occur. Depending where your nerve is, the height of the bone and size of the implant, the percentage of becoming numb changes. So I really can't give you an estimate  without examining you.
I'm sure you will be alright and the surgeon will take care of you.

Good luck!

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Majid Jamali, D.M.D. Fellowship trained in corrective jaw surgery

Expertise

Diplomate, American Board of Oral & Maxillofacial Surgery Full scope Oral & Maxillofacial Surgery, Orthognathic Surgery, Genioplasty and Anesthesiology I have completed an additional two years of fellowships in orthognathic surgery and anesthesiology field.

Experience

Faculty at numerous hospitals

Organizations
AAOMS ADA ASDA NYSDS

Publications
New York Dental Society Journal

Education/Credentials
Tufts University: Dental School SUNY Down-State Medical Center: OMFS residency Robertwood Johnson Medical Center: Anesthesiology fellowship Lenox Hill hospital: Orthognathic fellowship

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