Initial
Situation
Patient: 59 years, male
Clinical situation: 6 element Fixed Bridge #23-#28 with 12 years
Teeth #27 and #28 not viable for treatment
Surgical solution: implant #25 and tilted tuberositary implant #27
Restorative solution Provisional: MUAbutments + 3-unit acrylic bridge
Final: 3-unit Metal-Ceramic Bridge
Prosthodontist: Raquel Medeiros
Initial Clinical Situation
Patient complaint regarding the bridge on 2nd sextant: food impactation, bleeding around #27, mobility of the bridge.
CTScan – bone for implant #25 and no bone in the 26,27 for straight implant , enough bone for tilting implant in the tuberosity.
Treatment
Planning
1st phase:
- Cutting the metalceramic bridge distal to tooth #24
- Extraction of teeth #27 and #28
- implant placement: #25 and tuberositary + immediate acrylic bridge
2nd phase:
- Metal ceramic Bridge
Surgical procedure
Restorative procedure
Outcome
When you are faced with the extraction of the 1st molar, you know that the residual bone will not be enough for a short implant placement and the patient does not want to be without teeth… what would you do?
