Multiple teeth

Replacing a failing implant bridge

This patient had a failing implant bridge on the upper right: an implant placed 15 to 20 years earlier was joined to a loose tooth. The old implant and the tooth were carefully removed and a temporary denture fitted. Once the site had healed, new implants were placed, with guided bone regeneration to build out the tissues. A temporary bridge on the implants shaped the gum before the final bridge was fitted.

Before and after

Before
After

Step by step

Every stage of the treatment, in order. Photos from the practice archive.

Pre-op failing implant bridge at upper right hand side
Failing implant placed 15 to 20 years earlier, which was connected to a loose tooth through bridgework
Failed implant and tooth extracted
Temporary denture fitted immediately
Implant and tooth carefully and gently removed
Healed extraction site
Implants placed in situ
Implants with cover screws ready to be buried under the gum
Guided bone regeneration to build out the width of the tissues for a better aesthetic result
Implant site sutured closed
Following first stage impressions at surgery models have been poured and permanent abutments chosen
Implant supported temporary bridge made
Metal framework for permanent bridge made from first stage impression
Acrylic jig used in seating of permanent abutments
Healed site prior to fixture exposure
Permanent abutments tried in
Permanent abutments tightened in precise position using an acrylic jig
Final metal bridgework framework tried in for accuracy of fit
Temporary bridge used to develop the emergence profile of the teeth (how they come out of the gum)
Temporary acrylic bridge 2 weeks later
Temporary bridge 6 weeks later
Fully developed emergence profile of permanent abutments
Metal framework used for pick up impression for fabrication of final bridgework
Permanent bridge made and shown on model
Abutments just prior to final bridge fit
Final bridge in situ
Final bridge fitted
Smile with the final bridge in situ