Replacing Several Teeth

Email whitney@wholedental.com

IS bridgeWhen several adjacent teeth are missing, an implant supported bridge is an excellent way to replace them.   This type of restoration is similar to a regular dental bridge, but instead of being supported by your natural teeth the bridge is supported by implants placed in key positions to allow for equal stress distribution during chewing.  A bridge is attached to two or more implants.  The number of implants required to replace several missing teeth depends on many factors, including the quantity and quality of existing bone, your bite, and other anatomical factors. There are several reasons your periodontist and general dentist may recommend this type of restoration, all of which will be discussed with you at the initial consultation appointment.

Case Study 1

Deep decay beneath existing bridge in the upper left quadrant requires removal of the first and second molars

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The upper left first molar was extracted and a socket graft was completed.  The upper second molar was temporarily kept to allow the patient to wear a temporary bridge during the healing period following implant placement to maintain her chewing function on the left site.  Below is an image from the CBCT that was taken 2 months post extraction.

Two implants were placed to restore this area with a 3-unit, implant-supported bridge. The photo below shows the implant preparation using a surgical guide provided by the restorative dentist.

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3 months following implant placement, the implants were uncovered and healing abutments were placed

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Final restorations were fabricated and delivered by the restorative dentist.  Note the beautiful restorations and healthy gum and bone tissue surrounding the implants.

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Case Study 2

69 year-old male presented to a local prosthodontist with a failing dentition.  Patient’s chief concern was, “I know I need a lot of work.  I don’t like my smile but more importantly I feel like my teeth are falling apart and am looking for a longterm solution to improve both my looks and function.”

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A comprehensive treatment plan developed by referring prosthodontist for replacement of failing/hopeless teeth with dental implants.  A total of 9 dental implants were placed by Dr Weiner.

4 implants were placed in the maxilla (upper jaw) to be restored as single unit implant crowns:  upper right first and second premolar…

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… and upper left first and second premolar positions

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5 implants were placed in the mandible (lower jaw) – note the surgical guide verifying implants were placed in the correct position for restorations

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Patient was seen 2 weeks following surgery and all sutures were removed.  Patient noted minimal post-operative discomfort and healed uneventfully.

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After 3 months of healing, all 9 implants were uncovered by Dr Weiner  to allow for soft tissue development prior to being restored by Dr Mordis (prosthodontist)

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3 weeks following uncovery, the patient was placed in implant supported acrylic temporary restorations.  Note the dark spaces (“black triangles”) between his front teeth.  Dr Mordis worked on recontouring these temporaries until she was able to train the gingiva (gums) to fill in these voids for a much more aesthetic final outcome.

***Note this patient wanted a “Hollywood smile” with teeth in a bleach white shade – he was THRILLED with the final outcome.

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After nearly a year of treatment, the full mouth rehabilitation was complete and the patient could not have been happier!  This case illustrates how ANYONE is a candidate for implant therapy and shows how dramatically interdisciplinary dental treatment can change esthetics, function, and overall quality of life.

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Case Study 3

67 year-old male presented with a failing tooth-supported bridge due to deep decay on lower right first premolar, necessitating extraction

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The existing tooth-supported bridge was sectioned, the lower right first premolar was extracted, and a socket graft was completed

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Three months later, adequate bone volume was achieved and two implants were placed for an implant-supported bridge.  (Note that in this case, the healing abutments (“healing caps”) were placed on top of the implants the day of surgery, as the implants were very stable within the bone.)  

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Three months following implant placement the patient’s tissues appear healthy and the implants had healed.  At this point, the patient was sent back to his referring dentist to fabricate an implant-supported bridge.

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The patient returned to see Dr Weiner for a routine recall appointment 6 months after his bridge was cemented by his restorative dentist.   At this stage, the patient’s bone and gums were healthy and he was thrilled with his improved aesthetic, oral health, and chewing ability!

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