Fixed Prosthodontics for 5 unit span?

Last Updated: Nov 18, 2015

The specialist I referred a patient to, placed implants at #5 (UR 1st premolar, 14) and #9 (UR central incisor, 21). I feel that this is an inadequate number of implants to support a bridge in this case. Due to the curve of the arch, and the span, I’m almost certain that the bridge will flex under function and the porcelain will shatter. I’d love to have him add an implant in the middle of the span as a pier abutment, but the patient has a history of cleft palate, and a third implant is not possible.

Am I correct in assuming the bridge with 2 implants will fail under normal function even if it is fabricated out of occlusion? Should this be referred to a Prosthodontist Thoughts?
Thanks!

3 Comments on Fixed Prosthodontics for 5 unit span?

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Alex Zavyalov

11/18/2015

It is too late to talk about a treatment plan absence. Out of occlusion does not mean out of loading and porcelain cheeping is not a subject, because a metal frame can be fabricated rather rigid. Theoretically, two implants supporting a 5-tooth span defect might withstand mastication loading from removable denture antagonists only.

mwjohnson dds, ms

11/24/2015

You can use these implants but not alone. You need a third implant. Can you sacrifice 10 or 11 or both? Would prefer to have a third implant in #11 with FPD from 5-9-11 for cross arch stabilization and tripoding. Keep anterior guidance shallow or in group function.

Richard Hughes, DDS, FAAI

11/28/2015

I agree with Dr Johnson.

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