Healthy 68 year old gentleman, presented with all upper right teeth missing due to long term restorative failures. He is a non-smoker, with excellent oral hygiene. He was not interested in increasing the occlusal table in the lower right beyond the 45. He has a low smile line, and so emergence profile is not critical to his aesthetic outcome.
Teeth were removed, and three implants were placed, two immediately into the extraction sockets, as these were a similar geometry to that of the implants.
This bridge was constructed as a PFM, using high gold alloy. It was screw retained for retrievability, and abutment screws were torqued to 35 Ncm in each abutment. The access cavities were restored with cotton pellet and GIC. The occlusion was adjusted to give light shim stock hold in ICP, and gently increasing, concave, smooth guidance planes in a group function occlusal scheme.
This patient was offered the option of local anaesthetic alone, oral sedation, or Intravenous sedation. As he was not anxious, minor oral sedation along with profound local anaesthetic was used to provide a completely comfortable state.
