Treatment Planning Help

[dumbdentist]

Would love some advice.

We have a patient that is in a MUA situation. 6 implants.
35 y/o female. Petite. Implants were placed with the decision to NOT reduce 10 mm of bone to hide the transition line. I agree with the decision. This is not to discuss the surgery, this is more to discuss the prosth part. . There will be a transition line, as the restoration will be an FP1. My thoughts are:

1) just a plain old zirc restoration. higher chance of breaking/fracturing in the future. All digital now so if it does break the cloud can just poop out a new arch.
2) milled titanium with porcelain laid on top. repairs can be done in the future. lots of labour.
3) casted metal with porcelain laid on top. repairs can be done in the future. lots of labour
4) milled titanium with thimble individual crowns. lots of labour.
5) casted metal with thimble individual crowns. lots of labour.

would love some opinions... any experiences you may have??

thanks


Quote Reply

Report Edit

 

[TheLabGuy]

Opposing dentition, have a xray of implant placement?

 

[dumbdentist]

natural, failing dentition

no xrays

 

[CoolHandLuke]

all roads lead to rome, just glad you aren't here to whinge about the price.

you can either do monolithic or you can cut the job into bar+overbar, or subdivide further into bar+overbar+thimblecrowns

depends how much room you have in the bite and in the budget.

 

[dumbdentist]

all roads lead to rome, just glad you aren't here to whinge about the price.

you can either do monolithic or you can cut the job into bar+overbar, or subdivide further into bar+overbar+thimblecrowns

depends how much room you have in the bite and in the budget.

i thought you guys all worked for free? that's what I do >

restorative space is limited so maybe only CoCr with porcelein, maybe even lingualized/occlusal metal

 

[TheLabGuy]

natural, failing dentition

no xrays

I've always had much better long term prognosis going the fixed route. Six custom titanium abutments, break up the zirconia into two bridges, usually split at 8,9 depending on the implant placement. As you posted, tons of options, really depends on finances and which direction you and the patient are the most comfortable with.

 

[rlhhds]

To late now but should have done the bone reduction. Not a fan of FP1s failure in the making, ask me how I know. Even Dr. agrees and does not do any more FP1s. They are now going for the bone reduction to get the space we need.

 

[bigj1972]

all roads lead to rome, just glad you aren't here to whinge about the price.

Hasn't got the bill yet.