Your Opinion: How would you manage this case?
This case is presented by Dr. Emad Girgis
I have a 66-year old patient, male Caucasian. Although on medications, these are not contributing to any health complications. The patient had a bridge, done on combined mini implants and teeth, tooth #42had been extracted prior to this X ray due to root fracture . #34 was extracted from under the bridge due to fracture as well. The bridge has been there for about 3 years and the gingiva seems to be healthy around the implants; so, I am assuming there is good integration. #33 has a large periapical radiolucency due to poor RCT and clinically the retainer of the 33 is off from the finishing line, suggestive of movement in the bridge, the heads of the mini implants has been reduced by the performing DDS (the lower bridge came off and was cemented temporarily), mandibular posterior ridge is wide enough to add implants as needed
The lower bridge has to go and the patient doesn’t want a removable appliance. Upper bridges are OK .
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