Re: [ACEsthetics] Clinical question on implants # 6-11

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 iPhone

On May 26, 2013, at 9:34 AM, ARUN NAYYAR <arunnayyardmd@gmail.com> wrote:

This 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 abutments

She has 4 abutments,  #6,8,10 and 11

I 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 years

SO here is the Q  

 A 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 FPD

Or 

Q2:    Extract roots, pack bone, do immediate implants placement, immediate or delayed loading 

          And do SIX  individual implants /crowns   ( with guided surgery )

OR

Q3     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 input

Biggest Q is that before implants,  the only choice was to endo, core and a FPD.  Today we have the option of  implant supported prosthesis

We also know the ROI and long term value for the patient favors implants

4 endo + core + FPD  vs  4 implants +  FPD.  vs    6 implants and 6 individual crowns 

 Thank you

Arun

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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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