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Endo tips    Better Endo    Endo abstracts    Endo discussions

Bridge cement question


Subject: Bridge cement question
Date: 19th March 2001 05:53:38 PST

I'm a layman with a recurring problem that my dentist can't seem to
solve. 5 years ago my previous dentist recommended a bridge to replace
the precision partial spanning my 5 upper missing front teeth. It was
attached to 4 teeth -- 2 on each side. Occasionally I could feel that
it had become disattached and would go back and have it re-cemented.
Finally he used a cement that was not as strong but more flexible
which seemed to work.

Then I moved to NJ, and my Aetna dental insurance forced me to accept
only a small number of local dentists.

I didn't know it at the time, but the cement had again come undone on
just one of the outer attachment teeth. Decay set in. Feeling pain
there, I went to my (new) dentist and he said I needed a root canal on
that one tooth.

Unfortunately, this meant cutting off the last attachment point on my
bridge, resulting in my bridge now having just 3 attachment points. I
have had the bridge re-cemented 4 times now in the past 6 months
because it keeps coming loose (even though I am careful about what I
eat).

My questions are:

1.) What is the best cement for this purpose. My current dentist says
she is using the strongest there is, but I have reason to believe she
is not up to speed on the newest technologies.

2.) Do I have other options? Seems like an implant of at least one
tooth smack in the middle of the span would prevent the rocking motion
that apparently unglues the bridge. But the expense of  that plus
another bridge to mate with it is more than I can afford at this time.

I'm worn out from this never-ending problem. Any suggestions would be
appreciated.

Subject: Re: Bridge cement question
Date: 2001-03-19 10:04:24 PST

Rely-X (3-M) is an excellent cement that I use routinely.  I don't think
that I've had any failures with "normal" crowns and bridges to date.

For "Hail Mary" cases (usually repairs of existing work with poor
retention) I will sometimes use a resin cement like Cement-It
(Jeneric/Pentron) or Parkell's resin cement system.

It is not recommended to have mixed abutments with natural teeth and
implants combined.  Usually 3 abutments are enough *if* they are
prepared correctly.

You also could be bruxing or clenching at night to put unnatural forces
on the bridge.

Subject: Re: Bridge cement question
Date: 2001-03-19 10:06:24 PST


Ask your dentist if she has c&b metabond. This is an adhesive "cement" that
really holds those "special" cases that all of us dentists have from time to
time. Not all dentists use this cement so you may need to call around to
find one that has it. You also need to look at why this keeps coming out.
From your post it seems like you have a 9 unit fixed bridge with only 3
abutments(the teeth that hold the bridge)- if this is the case it sounds
like there is not enough support to replace that many teeth and implants may
be the answer. However, in my opinion,  the bridge should not come out that
often, and it may be due to other problems with the bridge(ie. how it fits,
how the abutment teeth are prepared, how the bite is, etc.), but it would
need to be seen to tell for sure.

Subject: Re: Bridge cement question
Date: 2001-03-19 12:48:09 PST

A nine-unit brisge I guess. Redoing the bridge with better preparations
should solve the problem .....

Subject: Re: Bridge cement question
Date: 2001-03-19 14:50:05 PST

We agree. Better preparations and/or C&B Metabond ......


Subject: Re: Bridge cement question
Date: 2001-03-19 18:46:06 PST

Well, I believe an xray showed the need for it and he said that he
could not get to the bad tooth without cutting the bridge. But hey,
what do I know?

Subject: Re: Bridge cement question
Date: 2001-03-19 19:30:05 PST

If an abscess was sighted, then access to the pulp space is normally through
the crown. This is a very routine procedure and it preserves the integrity
of the bridge.

Subject: Re: Bridge cement question
Date: 2001-03-19 19:30:05 PST

Unfortunately, this meant cutting off the last attachment point on my
bridge, resulting in my bridge now having just 3 attachment points. I
have had the bridge re-cemented 4 times now in the past 6 months
because it keeps coming loose (even though I am careful about what I eat).

Thanks to all of you who responded! I am amazed over your concern and
truly appreciate it. I had not thought about the night "grinding"
maybe I can get my dentist to whip me up something to prevent that.
You've given me hope that there is an answer. The bridge she made me
fits very well. In fact, even though it is uncemented, it still stays
in place and I can actually eat soft foods. One of the natural tooth
bases has some kind of "pin" sticking up out of it that fits into one
of the abutments.

My lost teeth weren't that bad to begin with. I was in a car crash in
the military back in the early 70s and the military dentist's easy
answer was to just pull 'em all out. Being a new recruit, and the
dentist having an oak leaf on his shoulder, I didn't think I could
protest that radical a procedure. I've been living with this problem
ever since.

Thanks again.
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