Cannot locate abutments in implant supported denture: suggestions?

Use a Talon 12 bur and start destroying the cingulum in the canines/incisives and the central fossa in the premolars. When you find the screw you got it. You have 3d orientation! Not that difficult. And your patient does know you are about to destroy that partial so... go ahead. You will use that partial as a screw retained temporary.

Just a suggestion is there a plan for the final prosthesis, those tiny posterior implants may not be usable. Is there a way to have a CT generated provisional in acrylic so that if the metal bridge or abutments are damaged you have a backup since you don't know where the screws are. Could be thru the incisal edges. You don't know if the implants will draw and the patient will need a period of provisional wear to adjust and settle into the new occlusion. If an abutment is damaged you can place a stock abutment and use the acrylic temp it will also help you plan for the new bridge. A nice trick is to have facial groves cut into the temp for easy visualization and fill them with light cure acrylic. This replacement will be labor intensive and I hope you charge the patient for this skilled revision vs being a hero. Best of luck thanks for reading

Another option could be four three unit bridges in the posterior adding 1-2implants if the existing bridgework is clinically acceptable, hard to tell without a photo. Reason why the patient wants removal? One other caution, new patient vs a patient of record, can the original dds be contacted for information? As previously posted once you begin work you " own " the outcome and expectations based on someone else's work, may want to get more information. Good luck!

I would begin with vestibular slash cuts where metal copings are thinner. The main problem is to reach a passive fit of the future metal frames, because of multiple different abutment angulations. To my mind it’s a typical case of prosthetic uncertain planning before surgical implant insertion.

Thanks for valuable suggestions. I have to remove this and replace with new protheses because patient is not happy with existing one. Can any body tell me from opg are there two abutmens in upper both central incisors attached to fixtures ?

Restore the Mandibular with segmented bridges. Remember Mandibular flexure. The maxill can be restored either way. Segmented is easier. As far as removal use lost of burs and water. Fee this out correctly this is a lot of work and you are assuming the responsibility. I do suggest more implants in the posterior mandible. Try contacting the prior restorative doctor for any information as per abutments, angulation, what kind of cement etc.

The bridges appear to be fixed restorations that were cemented. I would try to use a back action bridge remover. Dent Corp makes a great pneumatic one that attaches to your handpiece line. The reverse percussion usually is very strong and very brief minimizing trauma to the underlying teeth or implants and usually enough force to break the seal. Pt should be aware that the new implants are not ideal length. Nevertheless, I would think that the forces generated with the extended bridge or hybrid will not be that much greater and you have 4 more implants on which to distribute the forces. Make sure to tell us how this case turns out. I would go with a fixed hybrid.

Can you contact the previous restorative DDS? Verify that it is cemented, and they may even have a cast with the analogs in it (I always keep them for bigger cases). I'd have lab fabricated temp bridges made, then section the fixed bridges and remove with the back action tapper. Even if you rough up the abutments a little they will still be usable to cement the temp bridges. You're not going to use the abutments with the removable partials anyway correct?