Healthy 57 year old lady, presented with unrestorable Upper teeth. She is a light smoker, with poor hygiene. She was not interested in living with removable dentures.
Options once the unrestorable teeth were removed included doing either Full upper denture, an implant supported overdenture with two implants in the Maxilla anterior to the mental foramens, or Fixed bridgework. Options for material used for these bridges are varied.
Treatment Carried Out
Teeth were removed, trial immediate dentures were provided until there had been bone healing, and arches were stable enough to provide a predictable soft and hard tissue bed for implants to be placed.
The bridge was constructed of acrylic reinforced with alloy mesh. This gave a rigid support for the acrylic while being inexpensive. Acrylic teeth are not as durable as ceramic, but are highly aesthetic in the short to medium term (3-5 years). They are easily repaired by any operator. They are normally replaced with ceramic bridges once aesthetics and function are stable and the patient is happy. Abutment screws were torqued to 35 Ncm in each abutment.
The access cavities were restored with cotton pellet and GIC. The occlusion was adjusted to give light shim stock hold in ICP, and gently increasing, concave, smooth guidance planes in a group function occlusal scheme.
This patient was offered the option of local anaesthetic alone, oral sedation, or Intravenous sedation. As she was somewhat anxious, intravenous sedation along with profound local anaesthetic was used to provide a completely comfortable state.