Failing #6 FPD Abutment


The following case initially presented to me 2 years ago with a 4-6 FPD and ailing #6 abutment. Initially I tried to preserve #6 through conventional periodontal treatment and placed a single implant with immediate provisional #5. After nearly 1.5 years the patient decided to have #6 removed and I did not feel it was a good candidate for an implant as the risk of further esthetic compromise was high. Treatment consisted of removing the provisional #5 and extracting #6. The extraction site was grafted with porcine xenograft (Salvin Oss, Salvin Dental) and a pedicle connective tissue graft was rotated from the palate to cover the graft and augment the facial and closed with 4-0 chromic gut suture. A new screw retained bis-acryl provisional was fabricated (Provisa Plus, Benco Dental) with an ovate cantilever pontic and allowed to blanch the tissue in an effort to sculpt and shape the pontic site. The patient is expected to be in this provisional for at least 8-12 weeks and at approximately 4 weeks it will be removed and modified PRN.