Maintenance of Highwater Implant Bridges

Once upon a time I did many of these highwater cases. They worked out great. The biggest problem was the wear and discoloration of the acrylic teeth and mucosa. I definitely have those patients on a 3-month recall, as I do most large prosthetic cases (whether implant or not). I try to train the patient to use Thorton's Bridge and Implant Cleaners and wrap it 360º around each implant. If the patient builds up much calculus I coat the implants and tissue surfaces of the prosthesis with Sof-Scale for at least 5 minutes. That softens up the calculus so it can be removed easily with teflon or plastic scalers, or even wood toothpicks in a Perio-Aid. I don't ever use metal instruments on implants or implant abutments. In the very beginning I used to remove the prostheses every year. Then I changed to every two years. I don't see the point. I no longer remove them unless a repair is necessary. Nothing was accomplished by removing them. I don't think chlorhexidine is necessary in most cases except for immediately post surgery. Much more important is teaching the patient to floss properly. The Thorton's Bridge and Implant Cleaners are great. For someone unable to handle that I might recommend a Hydro-Floss as well.

I love highwater implant bridge due to the fact that they can last a long time. My oldest is comming to 11 yrs old. The acylic teeth do stain and they come off sometime. However they are easy to retrieve and cheap to maintained. It is unfortunate that for the so called "pressure" from a few demanding patients and more so from peers, this design is no longer in favour by the implant fraternity. Their advantages include easier to clean by the patient, lighter than full porcelain alternatives and most of the time look much better than "horse like" pink and white porcleain teeth. Lately I have so many referals from chipped percelain full fix bridge that are cemented to the implant, they are a murder to remove. An hour and half as opposed to an average of 5 minutes with high water design Yes I agree, that they do not need removing for routine cleaning, just use plastic scalers around them and they will be there for many years to come