Any ideas on this?

[drock]

Hey guys,

I got this case here and thought I'd throw this out to u all and see what ideas can be generated. The dr prefers a cement retained bridge option, however I think otherwise. From the photos of the denture in place u can see the placements of the implants indicated with a red marker. So u can see that the denture teeth are quite labially placed. I believe the dr wants to maintain the same labial profile and flange. I'm thinking a screw retain pfm bridge would work better and gradia gum to replace the lost labial flange. I'm just wondering about the issue of hygiene here with all the pink tissue placed there. With the liguallize position of the max ridge and implants and limited vertical I'm not sure what would be best. Any ideas would be welcomed here. Thx.

 

[BobCDT]

This is really a poorly planned case. No vertical room and the implants were tipped too far lingual for a cement retained case. A fixed case with this implant placement will result in poor hygiene.
If the implant are deep the tissue should be thinned to provide more room for materials. Either way, this case is better served as a screw retained restoration.
Good luck!