I have gum disease. I recently saw a periodontist, and he told me that I have significant bone loss around #23, 24 and 25. The peridontist told me that I would need to have these teeth extracted and replaced with a bridge. I asked about implants and he said the bone loss was such that it was very unlikely that I could get implants. I am 30 and concerned that the bridge is just going to fast track my healthy teeth needed to anchor the bridge, to decay more and I'll suffer more bone less in the affected area? Can you help me? Am I really not a candidate for implants?
I am very familiar with this problem as I have treated several patients with lower front teeth bone loss. Here is the solution we offered them.
Following extraction of the teeth, if possible and necessary, a site graft can be done to preserve what is there or augment certain areas. If this is not possible due to complete bone loss around the teeth, then teeth can be extracted and allowed to heal.
There are several bone augmentation techniques that allow regeneration of new bone and development of the sites for implants. The choice depends on whether it is a vertical or horizontal defect.
Either way, once bone is enhanced, implants can be placed to support the teeth without involving other natural teeth as in case of a conventional bridge.
With three missing teeth, typically two implants will be adequate to support a 3-unit bridge. I can send you link to a patient with very similar experience to help you see the possibilities. I do not consider a bridge as recommended by the periodontist, a good option.