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Question:
Topic: Fixed / Removable pros Tx Plan
Older patient has 21, 22, 26, 27 remaining with 30 yr old fixed bridge in place, 1 cantilever off each end. #21 decayed out from under.
I consider cutting off 20-21, ext root or endo and dome, cut off #28 cantilever and make RPD. Any other suggestions? Max is full denture. Implants not an option. ...Dentist from Pennsylvania
Answer:
Without understanding her bone levels, I can't discuss mini-implants and even though you mentioned no implants, sometimes a few mini-implants are well tolerated and will give her great retention and support with a new lower partial.
If that is not an option, then you would evaluate the denture, if it is good with good cusps,
possibility of maintaining or creating lingualized occlusion then you wouldn't have to touch it. If it is mobile or has allowed for decreased vertical due to tooth wear, now is the time to present a new denture.
The options for the lower are the following. Remove the cantilevered pontics and decayed root, then cut rests in the canines with distal and lingual guide planes and make her a lower partial OR if the bridge is poor remove bridge, endo with ball or locator attachments in the roots to create better retention.
The goal of treating someone to a better chewing level is always my priority so regardless of age, I present upgradeable options that allow people to continue to improve biting efficiency throughout their lives. In fact sometimes discussing implants will give people excitement they haven't
expressed before as they weren't given the option.
I have alot of elderly patients with 6 mx mini-implants or 5 traditional implants with no palatal
acrylic, the ability to taste and chew better and they are truly transformed. Hope this helps.
Wisconsin Reconstructive Implant Dentistry
Richard Winter, DDS MAGD
Winter Dental Associates
5323 W. Hampton Avenue
Milwaukee Wisconsin WI 53218
(414) 464-9021
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