Need assistance from the Dentalxp community for my own treatment

48 Rating(s).

Posted on By David Michalczuk In Bone Grafting

Good day to you all.

I've got a bit of a pickle with my dental case. When I was about 9 years old (this was in 1998), my brother and I went outside to hit rocks with some old golf clubs. On one of the swings, my brother swung back and clipped my lower lip and teeth #9 and #10. The teeth flew out completely intact. My parents rushed me to the hospital (instead of the dentist) and because they had no money or knew what to do, I've been living with those missing teeth since. Fast forward to 2015 (I'm 26 at that point), my bone dissipated in that area, and teeth #8 and #11 got close enough to where not even 1 tooth could fit.

I got braces that year and finally started working on this problem. The braces portion is complete finally and I have plenty of room for two new teeth, but of course there's a problem:

I have no bone in the area, and the recession is so extreme that there is no place to attach a bone graft to. As such, I've gotten a few treatment plans and was wondering if the community here can help give me a realistic take on what my options are. I, of course, would highly highly appreciate the input.

I have seen a number of dentists/specialists, but they've all had different takes on what I can do. Admittedly, money is a factor as I'm trying to figure out what I can afford.

The first idea I was pitched, even though it may get frowned upon) was to get dentures. Not a perfect solution, especially because I'm still in my 20s, but from a financial standpoint, and the complexity of my situation makes me open to this idea. I don't know the cost of this, but I assume it's my cheapest option.

The second idea is to extract teeth #8 and #11 (tooth 11 is compromised anyway and is being held in by my braces) and place implants there. Then create a bridge from tooth 8 to 11, utilizing prosthetic gingival tissue. This would cost me around $11,000.

My third suggestion was similar to the second, except the dentist said she is concerned that if I don't get any sort of augmentation, it could leave potential room for bacterial growth. She pitched the idea of utilizing (I believe it's called) BMP Infuse protein to regrow that area. Then doing a bridge from 8 to 11. That would cost me $16,000 or more.

In light of these options, are there any other potential solutions for my problem? Do the proposed solutions sound reasonable? If I'm willing to forego having perfect teeth and opt for an apparatus such as dentures, is that a wise decision for someone in my position?

Regardless, thank you all for you time and input. It is very much appreciated.


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David; I am truly sorry for your dental problems and need for treatment. The options provided to you by each doctor seems reasonable considering the lack of bone and tissue in the area and the poor to guarded prognosis of the teeth adjacent to the space.
Perhaps provide some clinical images to our community so they can get a better idea of how it looks when you smile and inside your mouth from the front and top perspectives.
Dr. Salama


Dr. Salama,

Thank you for your reply. I have uploaded two more photos of the actual smile. As you'll see, the gum in the area where my teeth are missing is thin, but it does have a bit of height.

Thank you,



Hi David
Based on the situation of the remaining bone here ,let alone the financial situation . I would have suggested what they call Maryland bridge from tooth #5 to tooth # 12 to compensate for the missing teeth #9&10.
In the future when financial situation allows bone grafting could be done and implants could be placed .

Dr Saleh


Thank you for your reply, Dr. Saleh.

I will look into this option.


360 Imaging