Can natural teeth be splinted to implants?

This is a trick question. Yesterday I examined a patient with six implants from 5-12 that were splinted with a one piece ceramometal fixed restoration. My associate at the time when it was made had wanted to keep the patients cuspid teeth since they were in perfect condition. I had explained to her that I thought they wouldn't add any support to the final restoration, because natural teeth move slightly an implants don't. Because of this they can separate from a cemented restoration and if any material gets trapped between the restoration and the natural tooth it will decay or intrude.

She still didn't want to remove #6& 11 and asked me help her design the case. We decided on a one piece restoration with telescopic copings on her cuspids (little gold coverings for the prepared teeth that fit into the fixed restoration). These copings would protect the cuspids from recuurent decay in the event that the bridge would become separated from the natural teeth.

My associate inserted the bridge over seven years ago, right before she retired but has come back to recement the bridge and clean the implant abutments numerous times ( the bridge was for her husband!). Yesterday I fixed the bridge because the porcelain on one of the teeth had fractured and we are planning a new version of the bridge. We took radiographs and I called down Dr. Philip Pack, the surgeon who placed the implants, to consult. We were all pleasantly surprised that the implants were all in good working order with minimal or no bone loss. His two incorporated natural tooth were still in pristine condition.

I fixed the broken porcelain with bonded composite and it looked quite nice when the restoration was re-cemented. It's really nice when the best laid plans of mice and men turn out to work out in the long run. My associates husband who had previously been a chain smoker has long ago given up his smoking habit and our next plan is to send him out for a consultation on having a sinus lift so we can have a couple of posterior molar implants placed. Hopefully this will help get some of the forces of of his anterior teeth and let him get rid of the partial denture he wears to help him chew.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/06/can-natural-teeth-be-splinted-to.html - http://lspindelnycdds.blogspot.com/

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