By using the multi-step, interdisciplinary passage a patient can successfully transition from a broken bridge to an implant-supported bridge, without interim dentures. A noteworthy exemplification is the action of Ms. W., a patient in sound health in her mid- 50s. This patient was referred to me by her habitual dentist and she and I collaborated on this case.
The patient arrived for her initial consultation with a loose anterior maxillary 10-unit, cantilevered bridge from 4 over 13 with teeth numbers 6 wrapped up 11 as abutments. These abutments were decayed and deemed periodontally and restoratively unsalvageable. A comprehensive Rontgen rays of the patient was taken before blastoff the procedure. This position occurred conscientious prior to my acquisition of an i-CAT cone beam 3-D imaging system.
My protocol nowadays is to haul both preoperative and postoperative CT scans. The CT scans feather me with images that project the shape and density of the bone with a factual three-dimensional rendering and demonstrate whether any bone grafting is expedient due to resorption.
Inclined today's dental treatment options, the lucid idea to her dilemma was dental implants. Dental implants bring the patient with a permanent, stabile notion that testament satisfy both her functional and emotional needs, without compromising speech, taste, aesthetics or mastication.
The patient had a couple of concerns. First, she did not thirst a sinus bone graft. Second, she did not thirst for to wear an interim denture during the implant treatment under any circumstances. Unsure provided instant load could chore on this specific case, we opted not to achieve all the implants at once and elected to bang with a two-stage approach.
At the headmost surgical weekend the loose bridge was removed. Using the bridge as a guide, I placed Lifecore dental implants in position of teeth numbers 4, 5, 12 and 13, respectively. This example was temporized by re-cementing the existing bridge on the six anterior abutments. At this point, a roundhouse transitority shell was prepared to be used as a temporary, after removing the six anterior teeth and placing six anterior implants. We waited three months to grant for curative and osseointegration to revenue place.
Three months consequent at the moment surgical visit, the patient arrived for extractions of teeth unit 6 completed 11 and prompt placement of implants on teeth numbers 6 down 11 using BioLok Silhouette implants. These implants were solid and treated in a single-stage fashion, by placing healing abutments at the duplicate visit. At the alike time, the four formerly placed implants, numbers 4, 5, 12 and 13, were exposed and passing coronet and bridge abutments were placed to base the fashionable brief bridge from numbers 4 fini 13. The bridge was then relined with cold-cured acrylic and was temporarily cemented with honour on numbers 4, 5, 12 and 13 and lambent vertical rests on the healing screws of teeth numbers 6 complete 11. The restoring dentist adjusted the bridge and the occlusion and the patient was dismissed for another three months.
At the six-month point, the patient returned to my profession where we removed the interim bridge, provisional abutments and healing screws and took an implant-level impression. Then everything was replaced and the ending idea was sent to Angel Dental Studio. The occasion was completed by the restoring dentist by placing custom abutments and porcelain fused to metal bridge from teeth numbers 4 wound up 13.
One could convey we envisioned the limitation corollary from the bare basis and it served as our operate washed-up the initial steps. Correctly accord was at last achieved now the verbal surgeon, the restorative dentist and the lab were in fixed message throughout the adequate process.
The patient was mere pleased with her results and cheerful that she never had to wear an interim denture.