Implant Treatment Plan for Replacing 9 thru 14?

Dr. E. asks:
I am replacing #9 thru 14 [maxillary left central incisor to maxillary first molar]. The space is currently edentulous. The patient has a maxillary fixed partial denture supported by natural teeth from #6 through 8 [maxillary canine through maxillary right central incisor]. I would like to establish a progressive anterior disclusion in an implant supported fixed partial denture replacing #9 through 12. My treatment plan is to place implants in #9, 11 and 12 positions [maxillary left central incisor, canine and first premolar] and to make a fixed partial denture connecting the three implants. I would place a pontic in #10 position [maxillary left lateral incisor]. I will later place implants in #13 and 14 positions [maxillary left second premolar and first molar] and splint two crowns. Would this treatment plan provide the best chance of success for this situation?

8 Comments on Implant Treatment Plan for Replacing 9 thru 14?

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Dr. Pratt

10/13/2009

My First comment is if you have to ask you probably should refer the case. I myself am a General Dentist and if I had to ask what the best treatment plan for the patient is I would refer the case and work with the specialist until I was knowledgeable enough to treat the case on my own without asking what the best treatment plan is. I suggest you attend some Advanced CE courses like Misch or Garg implant courses.

larry mclaughlin

10/13/2009

i dont know the answer, but your question seems reasonable. you are to be commended for consulting other dentists rather than jumping in and treating. good luck

sb oral surgeon

10/13/2009

your plan sounds good. you have implants in all of the key areas. However, when you do any case with multiple implants, make sure you do your homework. have a wax up done, talk to your lab. they can give you some great insights. remember that implants do not do well when they are placed two close to eachother, so look at the wax up and compare it to your bone stock to see if it can really be done. do you need to scan your patient? if these areas have been edentulous for a while you may run into undercuts, ridge width deficiencies etc... if you have done this and your surgical plan matches your patient and skill level, you will be pleased. remember that it is not hard to drill a hole and put in a screw. in a case like this your plan is what's important. like i said, just make sure your plan matches your patient.

A.M maxillofacial S.

10/13/2009

I agree with what s b said.

Dr. Dennis Nimchuk

10/13/2009

I'm a Prosthodontist that performs implant surgery. Your plan is totally sensible, both for function and for esthetic reasons. By leaving a pontic at the lateral site, you make the implant insertion easier and you will develop better looking teeth with embrasures that can be cleaned. You could do cuspid rise no problem because you are splinting implants together. If you didn't splint, then group function might be better. Most important is to use a surgical drill guide and of course take a Cone Beam volumetric tomogram. Also good luck.

mak

10/14/2009

sounds like a solid plan, well thought out. I think it interesting that most of the respondents feel that your treatment plan is a sound one (me included). I feel that your sharing your treatment plan is a sign that you are very conscientious of wanting to do the best for the patient...no harm in getting input from others who have done similar treatment. There's no such thing as doing too much pre-planning.

Dr.Amit Narang

10/16/2009

the more you plan earlier the less you suffer at a later date.. .. so dont worry.. its better to do a case late than thinking about your surgery later

Paul

10/23/2009

I'd probably do a 9x11x13x14 one-piece implant bridge.