#7 immediate load/comprehensive esthetics

126 Rating(s).


Posted on By Jason Witons In Anterior/Esthetic

Good morning,

This pt was sent for #7 treatment as Maryland bridge is failing. Full comprehensive therapy is likely has better alternatives. He is currently scheduled For CT scan. I plan to do a Wax up to see potential finished tx plan and demonstrate alternatives

If bone is adequate in #7 is this a good immediate load case as a removal temp will not be needed.

Alloderm could be done to generalized recession areas.

Ridge augmentation to LL and implants replacing missing teeth 18-20 can be done.

once CT is done I will update. Please advise on thoughts at this point.

Thank you,

Jason




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3 Comments

Hi Jason. With the limited information provided, my guesses/suggestions are as follows:
1) Is that decay on #8? If so, is #8 vital? Endo?
2) I doubt that the CT will show that area of #7 has adequate B/L width, even with a narrow, 3mm, implant, which will be necessary given the limited M-D distance available between #'s 6-8. Therefore, plan for bone augmentation in area of #7.
3) This patient has extremely prominent roots and very thin tissue, ergo the generalized recession. I would plan on also doing a CTG in area of #7, either separately or with your bone augmentation.
4) If the above is in fact necessary, I'm not sure immediate provisionalization would be a good option. Maybe you can re-utilize the bonded bridge during healing.
5) This patient will definitely benefit from root coverage or at least widening of the zone of attached/keratinized gingiva as it's not clear his recession patterns are stable.
6) Lower right and/or Upper left can both be options for implant therapy, but post the CT results first and we can revisit potential approaches.
Looking forward to your follow-up


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What a surprise, I completely agree with Henry. Hope to see you in Florida this February. regards and good luck Maurice Salama


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Jason, mount these models in CR and check the occlusion before loading implants . His anterior teeth are in harms way. Recession and wear could be one of the reason for that. You may have to treat other teeth to get the balance. Regards.


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