Implant Fixed Partial Denture Case: Recommendations?
Dr. D. asks:
Please see the radiograph below. I am a periodontist and have a patient who presents with an implant in #15 position [maxillary left second molar; 27] adjacent to #14 [maxillary left first molar #26] which has a failed root canal treatment and will be extracted. #13 [maxillary left second premolar; 25] has a root canal infection and is mobile and will either need root canal treatment or will be extracted. My primary treatment plan is to extract #14 and #13 and to cut the single crown off #15 and to place a 3-unit FPD. My alternate treatment plan would be to extract #14 and 13 and place 2 implants and 2 free standing crowns. What do you recommend?
7 Comments on Implant Fixed Partial Denture Case: Recommendations?
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yossi kowalsky
1/31/2011
First of all x-ray looks backwards . secondly take a pan or ct at least. Extract place 2 implants and do 2 connected crowns. why cut off a good crown and then again why not connect the new crowns
rs dds
2/1/2011
i always connect posterior maxillary implant crown because of poor quality bone. if the patient agrees i would redo #15 and connect to 13,14 yhis prolong life of the implant.. good luck
Gregori M. Kurtzman, DDS
2/1/2011
Looks like the spacing will not be easy to place two implants (at 13 and 14) and have 3mm between the implants and 2mm between implant and natural tooth. I would suggest extract 13 and 14 and place an implant at 13 that is 2mm (at least) from the natural tooth and restore with a 3 unit bridge.
Ljungberg
2/1/2011
I would suggest extraction of #14 and #13 and replace with just one single implant. It seems to me that the #14 was hemisected and rotated
If you felt that the space management is difficult, just replace the crown on #15 at the same time when prosthetic part of the #14 is to be made.
Ljungberg
2/2/2011
Please check carefully about the position of the teeth. If the so-called #14 was not hemisected, the so-called #14 should be #13 (maxillary left 2nd premolar). The right long-rooted tooth should be #11 (maxillary left canine).
If the above is correct, the edentulous space must be replaced by 2 implants.
Roy Joseph
2/4/2011
Ext and 2 implants with splinted crowns
Guy Carnazza
2/9/2011
For a more predictable outcome I would suggest to extract #13, and #14 and graft the area. Trying to immediately place will be difficult, especially the molar because of the p.a.p. and close proximity of 13 and 14. Clinical judgement at time of surgery will dictate final outcome.
