Cleft Palate: Are Dental Implants an Option for Me?

I’m a cleft palate with missing jawbone over the cleft. The cleft is currently covered by a bridge anchored to one tooth on each side of the cleft where the jawbone is missing. I once had a removable partial denture but hated it and could not live with it. So orthodontists moved teeth into place and then the dentist was able to make the bridge. Now my main anchor tooth for the bridge, right in the middle of my mouth, has had to have a root canal. It was tricky doing the root canal through the bridge, but they did it. That’s my current situation.My question is a deep worry I have about the future. Here we have a three-tooth bridge being supported by a tooth with a root canal. The situation is obviously precarious for that bridge, in the long term, since it’s all relying on a dead tooth that was just barely saved. Because I could not handle having dentures, I suggested to various dentists that when this bridge finally gives way I would go for dental implants on each side of the cleft and then have a bridge over the cleft built from the implanted tooth. Some dentists were concerned that this was not possible because implants don’t have the flexibility that real teeth do and that they could not handle the twisting and turning and uneven impact. And thus, over time, being part of a bridge over a cleft would weaken the implants and doom the project to failure.In short, I’m told, that when this root canal tooth goes, or if this bridge breaks, my middle tooth is done for because its been shaved down too much, since this is now the second bridge to be put on that tooth. Hence, we would tray a four-tooth bridge, and hope it would hold, presuming the remaining tooth could even handle any more shaving down for a third bridge. And then, if that failed, I’d be doomed to wear a partial, which is even worse than dentures, as far as I can see from my acquaintances.Is it really true that dental implants could not survive under the condition of being part of a bridge over a cleft? My self-esteem is so battered from my life as a cleft palate, which has been very hard, that I can’t see dealing with a partial-removable. Is there any implant technology upcoming that might be able to help me?

6 Comments on Cleft Palate: Are Dental Implants an Option for Me?

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Dr. Carlos Boudet
11/12/2015
You need to have a GP or a Prosthodontist with experience treating cleft palate patients examine you. Part of the necessary information to formulate the best plan for your particular case will require a conebeam CT scan to determine the volume of the bone available in the event that you would require implants. Your case may or may not require procedures such as bone grafts that may require an interdiciplinary approach involving other specialties such as an oral surgeon. Adequate records and a good treatment plan by an experienced GP or Prosthodontist is your first step. Good luck! Carlos A. Boudet, DDS, DICOI
Theodore M Grossman DMD
11/12/2015
Treatment planning must take into account: 1) the length of the bridge span/between abutments. 2) the quality, density of bone/type D1-D4 3) the opposing dentition/occlusion 4) functional forces & parafunctional habits 5) A Fixed Bridge or removeable bridge (with implant attachments/smaller than your previous partial)- giving more flexability. 6) The possibility of multiple implant fixtures.Patient treatment planning will be paramountGood LuckTheodore M Grossman DMD
Daniel
3/22/2016
I also have a bilateral cleft pallet and have my front 4 upper teeth missing. (UL 1,2 UR 1,2 in dental terms) I was told I did not have enough bone there to support implants. My only option is to have a bridge meaning my UL 3 and UR 3 would need the shaving done to support the bridge. Possibly even my UL 4 and UR 4. The main problem I have Is that this treatment is veery expensive, £400 a tooth and I may need 8 to complete a secure bridge. I cannot afford upwards of £3200. I have had to learn to live with it. My hare lip though was pretty bodged up so my lip is too thick to even see the missing teeth. I should also imagine to get that fixed would also cost silly money.
Ian Aspinall
9/8/2017
I was born with a cleft lip and palate I have no teeth in my mouth and they are considering implants I am worried like yourself that to have this done because the implants would have to go into the bone and would the bone be strong enough for them as in the past I have had many operations and is it worth all the pain if it does not work. Ps what every you decide good look.
Olinda
3/22/2019
I was born with a cleft palate and the left front three teeth were missing. They did a bridge with two teeth that were there with root canal on the first tooth then secured it to the opposite tooth. this was done when I was 16 and now I am in my mid 50's and this bridge became loose and came out. It lasted for a long time and if I could do it again I would. I am having trouble in my area of finding a dentist who will even do anything about it. I am looking on my own now to try to find someone who will work on my teeth situation. The pricing is truly high from what I was informed by general dentists. I am not sure of how they will fix it this time. I would consider complete top removal with implants but not sure if I have enough bone to do that.
LYN
9/10/2019
TRY TO GO TO a dental school, I did and got a bone graft and then a implant. GOOD LUCK

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