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Oral Surgery/is facial appearance the same whether pontic (as part of a bridge) is used or an implant is used


Is there a difference in facial appearance whether a pontic (as part of an onlay bridge) is used or if an implant is used?
#19 was extracted 10 yrs. ago, and I got a gold onlay bridge at that time. This bridge recently broke, and I want to know for facial appearance sake, should I get an implant instead of a new crown?
I must point out that #16 was extracted and #15 will likely be too. Because of a severe furcation near #15, I don't think an implant will be possible in this site. Should extractions of #16 and #15 influence my decision to get an implant for #19? Can three extractions on the left side of my face cause it to look distorted?

Michael, Thank you for your question. Missing teeth can change the way the face looks. The face will appear different with many extractions because the teeth and bone support the soft tissue on your face. The way the teeth are restored should not matter and the facial appearance should be the same regardless if they are replaced with a bridge or an implant. There are other differences to consider when making the decision. The gold standard these days is to replace with an implant. The reason why are many but a few include: no need to destroy teeth on either side of the implant, long term stability is much greater with an implant vs. a bridge, and if the implant fails you can replace the implant but if the bridge fails you will need to replace many teeth or all the teeth that were involved in the bridge.
I hope that helps.

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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