TREATMENT PLANNING FIRST UPPER MOLAR

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Posted on By ANNA DANAKI In Occlusion

Lady, 65 complains of food impaction on her upper rhs molars. Clinical examination reveals carious lesion on Uthe first molar. PA shows leaking bridge on first molar, bone recession and recurrent decay on the first premolar. Removal of bridge was advised with an aim to review the molar and trt plan accordingly. Temporary bridge was placed for a week. new PA taken. No pain reported. My question
-should I replace the bridge with a new one?
-or should I make a bridge and include the second molar or premolar?
Many thanks in advance


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3 Comments

Anna, IMHO it would seem that these abutment teeth are no longer predictable abutments for a fixed bridge. More information is needed including periodontal charting, MGJ, mobility, amount of KT along with occlusion parameters. However, even if all of these parameters are perfect, the crown to root ratio is compromised and these teeth should be restored individually. I would recommend individual crowns and an implant. To double abutment the distal only serves to perpetuate the problem and is short term. Good Luck!!


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Terry gives you good advice. But why not consider individual crowns and an implant if the second molar is stable?


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Anna, base on the info you provided, in my opining i will crown #5, implants for 3 and 4 with individuals crowns. Now it seen to me that #2 it may be periodontally compromised(furcation), evaluate this and if it is ok crown it. If it's not then the question is if you will replace it or no?
if you do, how?. with two implants and a bridge or three implants? ether way is fine.
Regardless the treatment selected I will finish the case with an occlusal splint.
Good luck!!!


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