An Interesting Case Study


When a patient arrives with a lot of existing major dental work which is no longer serviceable, it’s necessary to evaluate the situation and previous dental work  in order to decide where  current treatment should go.    Case in point:

A new patient in her early 70s with a history of a lot of dental work over the years, recently came to our office.  On her lower arch she is missing all molars and premolars on one side.  On her upper arch she is missing her 4 incisors which is restored with a removable partial denture.  She is also missing a first premolar which has been restored with a fixed bridge.  She does have some medical issues which seem totally under control.

Her most immediate dental situation is the 3 root canals which are needed to treat decay that has caused the pulp to die as seen on her x-rays.  In particular, there is a lot of decay on the upper canine which supports her 3-unit fixed bridge.

She is satisfied with her upper partial denture, but the bridge, with a great amount of decay on the canine, must be addressed.

Dental Treatment Plan Choices

The first consideration is to decide if implants would be the way to go.  In this case, the treatment would be extensive and costly.  Since she has done well with the bridge and partial, that would be a more cost effective way to go.

The next decision is whether or not to convert the missing first premolar to be part of the partial or construct a new 3-unit bridge.  In this case I can fabricate a new bridge to fit under the partial and keep her partial for future use of at least 5 more years.  So this is the treatment plan I’m going with.  She has already had the root canal on the canine which supports the bridge.  The next thing to do is to cement her dental post and fabricate a core for her new bridge.  Arrangements have been for the laboratory to pick up the impression with the partial and then return that to her after the models are poured up.  Within 2 weeks she should have the permanent bridge ready for delivery.