Economical implant case: re-treat or remove and replace?

Fine , works well on implants less so on natural teeth especially when anteriorly ( Pontic ) like this case and you probably have a nice looking " papilla " as well. Financial considerations are an important factor in treatment planning as we are doing the paying but beware and keep within an accepted parameter . Peter

Hi, im fairly new to implant surgery but i have a question for you and the posters. The extraction socket of the 14 looks fairly recent. How long after the extraction was the implant in site 15 placed? And as the 14 socket heals and remodels, will it have an effect on the implant, specifically the bone levels around it?

Always a possibility, but not likely implant will get compromised, the bone is there and implant will protect and preserve it. Site preservation was done utilizing PRF. Thanks

Probably fine, but it depends upon the supporting occlusion. If the patient has bilateral molar occlusion then the load on the implant site is considerably less. Certainly, financial constraints are real world and this solution has precedent.

Hi Dr L , Woolfs Law 1891 answers your question ... Peter

Woolf's law is poorly named as it was an opinion never tested and therefore never a law. We've used it as a guide to generally good effect however it is defined by the peri-cemental area of the tooth abutments. Obviously Woolf would be surprised to see cantilevered hybrids today.

Seems to me that you have your tooth numbering in reverse because the implant is in the # 4 site, not the # 5 site. As per cantilevers, I would say no! However the rules are changing. Time will tell.

Hello Mike, this treatment is not my first preference. However, there is more than enough implant for the prosthesis. You are correct that narrow occlusal and flattened tables are needed. The weakest link is the screw holding everything together. Chances are this will work just fine!

If you treat the early periodontal problems on tooth #3 I think this tooth should last many years...I would not be so quick to be treatment planning for its extraction. Let us remember that implants have just as many periodontal issues as natural teeth. Who knows, by placing an implant with a distal cantilever you may be building in more future problems in an effort to be prepared for the loss of a natural tooth, which loss should not occur for many years with proper treatment and maintenance

I see a disaster waiting to happen in the future (5-10 years)

Strangely not I have two cases of cantilevering anteriorly from the early 90 s and neither have lost more than a mm of bone. The management of of bio - mechanical forces but Ti Implants is an interesting area and whilst cantilevering natural teeth on posterior teeth will mostly lead to issues of bone loss . As Richard said not the plan of choice but no problems . Peter

when u hv absolute width avail of with very good papilary area as not much bone loss why a cantilever why not 2 unit integral if economy was a very relevant factor in planning in such cases.in near future i dont find any dismay but the occlusal sheme will make u to have a furtehr extension of restoration in relation to molar endo treated one .then again u willhave a entire new range of loading criteria which will be economicaly strenious for u. but still then enjoy the cantilever as its not causing any problem, regards.