Agree Bob, but as recent as10+ years ago a major % of Dentists had only the endo, perio, core ,bridge option
I am sure there are many even today who would select that route
John raised a good question.
We are always looking for the best for our patients and have the learning, not the patient
Let us wait and see what others with similar clinical situations have addressed the issue
Arun
On Sun, May 26, 2013 at 6:35 PM, Bob Perkins <bperkinsdds@gmail.com> wrote:
Not option 1, I am sure of that
Sent from my iPhoneThis morning a patient called and said she had snapped her anterior bridge off at tissue height.--He denied any trauma... i think she bit into something hard with enogh force to snap the abutments.
No pulpal exposure!!! on any of the 4 abutmentsShe has 4 abutments, #6,8,10 and 11I made the prosthesis as a part of a recon some 15years ago.She wears a bite guard and is v compliant with 3 m recalls.All the other 22 restorations are doing well at 15 yearsSO here is the QA intelligent patient... well read and does her due diligence.Q1 Do endo on 4 abutment teeth, then posts, surgical crown lengthening and a 6 unit 4 abutment FPDOrQ2: Extract roots, pack bone, do immediate implants placement, immediate or delayed loadingAnd do SIX individual implants /crowns ( with guided surgery )ORQ3 Extract roots, pack bone, do immediate implants placement, immediate or delayed loading
And place THREE or FOUR implants and make a 6 unit splinted prosthesis. ( with guided surgery )Interestingly when we consider 4 endo, surgical cr lengthening, 4 cores + a 6 unit prosthesis over implants. the implants provide a longer clinical life and will be expedient and cost a few more $$As I debate this in my own mind, I reach out to you for inputBiggest Q is that before implants, the only choice was to endo, core and a FPD. Today we have the option of implant supported prosthesisWe also know the ROI and long term value for the patient favors implants4 endo + core + FPD vs 4 implants + FPD. vs 6 implants and 6 individual crownsThank youArun--
Arun Nayyar DMD,MS. Atlanta, Georgia
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Arun Nayyar DMD,MS. Atlanta, Georgia
Private practice limited to Prosthodontics - Imagix Dental Group
Former Director of Fixed Prosthodontics - MCG School of Dentistry
Principle Research Scientist ( Adjunct ) @ GaTech -GTRI
Clinical Director - Center for Dental Technology @ GaTech - GTRI
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