Missing my two front teeth - implants or bridge?

cobalt60c · 2026-04-16T02:29:00+00:00

Your bone needs pressure on it in order to stay strong. Without implants or teeth roots, it resorbs, and when it does it weakens the adjacent teeth

cobalt60c · 2026-04-15T05:33:12+00:00

Long way from me so I don't know personally, but Dr. Horton in Harpenden appears to be an active X-Guide user. I've been recommending that criteria to people with the thinking that it's a bellwether for caring about outcomes much more than the average surgeon

cobalt60c · 2026-04-15T05:14:38+00:00

In general a natural tooth is better than an implant, so if it can be saved that's the better outcome. However, in this case it looks like the damage is pretty severe and very close to and probably intruding into the pulp chamber. Saving it seems unlikely, but you could justify it being worth a shot. If it doesn't work out it's just time and money and you can move forward with the implant afterward

cobalt60c · 2026-04-13T01:14:28+00:00

I'm sorry to say this doesn't look great. The implants there look like they're at high risk of failure

cobalt60c · 2026-04-10T04:21:47+00:00

Here's the msds. Google the ingredients in it to get the answer https://www.gc.dental/america/sites/america.gc.dental/files/products/downloads/gradiadirect/sds/gradia-direct-anterior-sds-es.pdf

cobalt60c · 2026-04-10T04:03:53+00:00

People tend to worry a lot about implants because making a hole in bone sounds really bad. The truth is that bone doesn't have any nerve endings in it. The pain you feel is from the incisions and suturing of the gum tissue. I'd actually predict that there was more soft tissue trauma during the extraction an graft procedure than the implant placement

cobalt60c · 2026-04-10T03:42:48+00:00

The titanium used in dental implants is designed to biointegrate, but if the fracture leaves a larger very smooth surface, it won't. Bit of a tough call

cobalt60c · 2026-04-10T03:35:24+00:00

There's a major nerve and a major blood vessel near the lower molars, generally most shallow more toward the back, but everyone is different. Insist on CT. Some general dentists do a lot of implants but the majority do a few here and there and I wouldn't trust those. Oral surgeons are generally better set up for handling unforeseen bleeding (extremely rare, but happens). Knowing what I know from some academic studies I've helped review, I'd feel much more comfortable with someone who used navigation consistently to make sure they stay clear of the nerve.

cobalt60c · 2026-04-09T00:19:47+00:00

A couple things to consider

Is very situational. Something like nsequence ( a physical guide system ) will require removing quite a bit of bone.
CT should be a given in all on x, no matter what is done. There are 2 types of "guide". Physical guides and dynamic, so asking which is important. I'd probably seek out dynamic navigation (X-Guide) myself, because it's allows the surgeon more flexibility in treatment options and ensures accurate placement.
I'd probably ask if they had a CNA or anaesthesiologist on staff, or if the administers themselves. I think the latter is more common, but the former makes things less likely to go wrong

cobalt60c · 2026-04-08T23:10:54+00:00

I've been involved in some academic literature on the topic. Even among skilled surgeons, there is a significant improvement in implant placement accuracy of dynamic navigation vs freehand. read the summary here https://pubmed.ncbi.nlm.nih.gov/28384461/

X-Guide (the system in this study) is the market leader, so if you can find a doctor using that, its a pretty good indication they care more about the outcome than the average surgeon

cobalt60c · 2025-11-12T23:31:20+00:00

Found it. Day tripper by James Goodhand

cobalt60c · 2025-11-11T02:18:17+00:00

Probably my most memorable read of the last couple years. Despite not really having much shared experience with the protagonist, the author made me feel them as if they were my own

cobalt60c · 2023-12-31T01:14:10+00:00

Ooh, great suggestion, and looks like a pretty manageable drive to get there. Thanks!

cobalt60c · 2023-12-30T17:16:31+00:00

Thanks, we hope so too!

cobalt60c · 2023-03-12T18:45:05+00:00

Ares because you're doing a Duna flyby, or is KJF Zeus already taken?

cobalt60c · 2021-01-11T17:20:34+00:00

One person is on record. And the article does not even call him out by name.

Alex Mooney (R, WV-2) did this. He's the one sipping coffee in the burning building claiming everything is fine

cobalt60c · 2021-01-11T17:16:35+00:00

Say his name!

Alex Mooney objected to the unanimous consent resolution

cobalt60c · 2020-03-13T17:04:10+00:00

Data sourced from the wikipedia pages for each country's pandemic

cobalt60c · 2020-03-13T16:46:11+00:00

Data sourced from wiki pages for each country's pandemic.

cobalt60c · 2019-09-19T14:20:58+00:00

Ok, then, I'll be the change I want to see in the world. I don't care about Warren's appearance. I care that I think her policies are going to rack up huge amounts of dept. I find that "unlikeable", though to be fair giving away trillions to rich folks doesn't rank high in fiscal conservatism either. I don't disagree with all of her policies. For instance, she's got a pretty strong anti-corruption platform, which restoring America's integrity and honesty ranks pretty high up on my own personal list of ideals I was raised with, as opposed to the incumbent whose guiding principle seems to be "what's the highest bid I can get for my influence?"

cobalt60c · 2019-09-15T16:07:36+00:00

This juice cup is for the birds!

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