Question:

How do implants compare to two missing teeth. The last upper molar is a solid capped tooth, then two missing teeth and then another capped tooth. I previously had a removable one tooth bridge in this spot, and liked it better than the fixed bridge on the other side. It was easier to clean and felt better chewing.

Answer:

Contraindications to Implant Placement (NIH Consensus Conference

• Acute illness
• Terminal illness
• Pregnancy
• Uncontrolled metabolic disease
• Tumoricidal radiation to implant site
• Unrealistic patient expectation
• Improper patient motivation
• Lack of operator experience
• Inability to restore the prosthesis

Treatment Planning

• mounted study casts
• radiographs (corrected for magnification)
• evaluation of edentulous space (mesiodistal dimension); orthodontics may be necessary to gain space
• evaluation of soft tissue contours; soft tissue management may be needed to gain ideal contours
• evaluation of adjacent teeth; caries control may be necessary, periapical pathology may need to be addressed

Interarch space must provide enough room for prosthetic components

Fabrication of an Interim or Transitional Partial Denture

Step 1 (Clinical):

• Alginate impressions to generate casts
• Jaw relation records as needed
• Shade selection for acrylic denture teeth and resin

Step 2 (Laboratory):

• Bend and add wire clasps if needed
• Set denture teeth into position with wax
• Lubricate (alcote) teeth and labial surface of cast
• Plaster matrix of teeth and labial surface of cast
• Remove all wax used to set teeth
• Readapt teeth to position with plaster matrix
• Drill retentive holes in bottom of plastic teeth; teeth may also need be made shorter to allow room for acrylic resin
• Add rope wax as a finishing line for the acrylic resin
• Add powder and liquid repair resin
• Place rubber band around matirx and cast
• Place in pressure pot for 15 minutes
• Finish and Polish

Step 3 (Clinical):

• Try-in of transitional
• PIP
• Adjust occlusion and clasps

Step 4 (Clinical):

• Homecare instructions
• Remove at night; place in water; clean with tooth brush; etc.

Related Resources:

removable vs fixed bridge – Part 1

For more information:

Go to the Crowns, Bridges, Dentures, Implants health topic.