Replacing a metal-ceramic bridge with an implant-supported prosthesis

Abstract

A 64-year-old male patient reported displacement of a metal-ceramic bridge in the area of teeth 13-23, 25. Teeth 11, 12, 13, 21, 22, 23, 25 were extracted, four implants were placed, and on them a temporary prosthesis was installed for a period of 4 months. After this period, a permanent cement-retained PFM (porcelain-fused-to-metal) bridge was installed

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Introduction

A 64-year-old patient, after long-term use, had a displacement of the bridge supported by the roots of his own teeth. This situation caused great discomfort to the patient. It was decided to remove the bridge and teeth 13-23, 25 and make a partial restoration supported by both newly placed implants and on the implant that was at the time of treatment.

X-ray of the patient with a displaced bridge prior to the procedure

This clinical case is of interest to practicing dentists due to the large amount of work involved and the difficulty of combining new and previously placed implants in one design.

Clinical Picture

Bridge displacement and destruction of treated teeth. The bridge and remaining teeth must be removed.

Treatment Implementation

First, the bridge was removed and the following teeth were extracted: teeth 11, 12, 13, 21, 22, 23 and 25. Then, implants were placed in the position of teeth 13, 11, 21 and 23. The following dental supplies were used:

• UH8 Pure&Porous Implant Ø4.2 L10 Internal Hex RP – 1 pcs.
• UH8 Pure&Porous Implant Ø4.2 L11.5 Internal Hex RP – 3 pcs.

Angled cement-retained abutments

Additionally, temporary prosthesis was made, which lasted 4 months; after this period, the prosthesis was replaced with a permanent PFM one: partial restoration supported by newly placed implants and by an old implant at the area of tooth 27. Old implant supported bridge at the area of teeth 14, 15, 16 was kept. Excellent aesthetics was achieved.

Final result – smile angle

Final result of the partial restoration

12 months after the surgery, control X-ray was taken showing a good result in terms of maintaining the volume of bone tissue and osseointegration of the implants.

Conclusions