Bridge replacement. How to treat!

142 Rating(s).


Posted on By Ben Lashley In Implants

42 year old female with a bridge that has replaced missing lateral number 7 for many years. Multiple replacements have been successful but now patient would like a better esthetic result. One option would be to remove bridge and place implant in the lateral position and replace crown on 8 with a new esthetic crown. This will involve both hard and soft tissue augmentation with either GBR with simultaneous implant placement and CT graft or Graft and two stage implant placement possibly Khoury technique with multiple CT enhancements. But what of 8 in this case? It has been compromised and re-treated RCT at least once to my knowledge. It is a more than 20 year old original treatment RCT due to trauma. What if in 5 years it fails and needs and implant? We know two implants next to each other would be an aesthetic disaster. Should removal of number 8 with or without PET technique and cantilever #7 with tunnel CT graft at final placement be considered now? Honestly less complicated and possibly better long term outcome? Less complicated grafting with no hard tissue involvement? A nice tunnel with CT could be done first and then PET replacement. Possibly one more soft tissue augment at final placement. What do you all think?

Ben

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3 Comments

My current trajectory with this case is to augment the tissue anterior to the central and lateral with a tunnel ct graft. Then replace the bridge with an all ceramic option with a cantilevered lateral for better esthetic result. Going to leave the implant option in my pocket for a while longer on this one until forced to by the failure of the central.
Ben


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This is exactly what I would do!
Best regards and thank you for sharing
Snjezana


Reply

Ben, I think you have many options here starting with what you suggested but when the central fails it is PET Time! Great seeing you in Vegas at the XP Mastersweek. Dr. S


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