Prosthetic plan with non-removable temporization: suggestions?
67 y/o female in good general health, GERD presenting with near-rampant caries. 32/42/45 non-restorable. Would like implant/restorative solution with no removable phase.
Tentative plan is:
1. Basic restorative on 33/43/44 to ensure restorability
2. CBT scan with intention to place implant 45/32/42, place a temp. bridge 31/41 w 2 cantilevers. Bonded cantilver to replace 45.
3. Use Simplant stent to ensure a path that helps ensure prostheses will be screw-retained.
4. At exposure time,, remove 31/41 and place temp bridge from 32/42 implants.
Planning to use BioHorizons LaserLok 3.5 implants.
Any suggestions or concerns? I’m fairly new to placing.
Initial pan
7 Comments on Prosthetic plan with non-removable temporization: suggestions?
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Alex Zavyalov
9/3/2014
From this X ray it is not clear why you consider these teeth functionally useless and non-restorable. So, the initial treatment plan should be postponed until you get a better image.
CRS
9/3/2014
I like the fact that you are attempting to determine restorability. I would be very conservative with cantilevers. Good Luck!
Anna
9/4/2014
Have you thought about an all on 4 procedure?
Robert Penning
9/5/2014
My post question wasn't about restorability - I also took PAs but didn't post them. I did pulpectomies on 32, 41, 42 to relieve pain while I have a CBCT done. Caries is too deep and is subgingival. 45 has grade III mobility. GERD is not under control despite efforts so do not think extensive restoration efforts are a good direction.
Robert Penning
9/5/2014
Patient stipulated that she does not want to repeat all-on-4 on the lower. Prefers to keep a few teeth for a number of years and then add as needed. Patient is high dental and otherwise IQ.
Robert Penning
9/9/2014
Hi - I could post PAs of the teeth for you but that is outside the scope of my question. To clarify, I was thinking of
1. prep'ing 31/41 for temporary crowns
2. extracting 32, 42 and placing implants buried and then
3. placing a 4 unit temporary bridge with 31/41 as abutments and 32-42 as pontics
4. keeping the bridge until the 32 and 42 are restorable,
5. extracting 31/41 and placing a 4 unit permanent bridge from 32 to 42.
Thanks for reading
CRS
9/11/2014
I like the conservative staging I think it is a good plan.
