A patient with old fixed work in the upper jaw, carried by teeth that had since lost their bone. The bridge did not hurt — it simply moved a little more each year, and the gums around it bled.
The question was not whether the bridge would be remade. It was whether the new work deserved to rest again on teeth that had already given up, or on support that does not depend on them.
The CBCT answered it: the bone in the anterior region was enough for implants, provided they were placed accurately. The teeth carrying the bridge were not.
CBCT, intraoral scan, face scan and photographs — one appointment, in the practice.
The teeth that would exist at the end were designed first. The implants were then placed underneath them.
Stackable guides: the same reference serves the extractions, the bone reduction and the placement.
The patient left the same day with fixed teeth, made from the design he had already approved.
After healing, the definitive work copies the provisional that had already been tested in ordinary life.
That was his condition from the start. Because the implant positions were known before the surgery, the provisional was already made when he walked in.
The second change is less visible: the new work no longer rests on teeth that were deteriorating. Whatever happens to the rest of his teeth does not take the restoration down with it.
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