Irvin asks:
I am having a full arch restoration done and a titanium Nobel Biocare was ordered. The first fitting after fabrication was arranged and the dentist installed it in three pieces. I was told that some of the abutments placed re-directed the angle of the implant. However, those special abutments were not in place when those long rods were screwed in and the impression taken. Should those special abutments been in place when the impression was taken?
Is it possible the bridge was cut apart to accommodate the installation of the special abutments after the fabrication? If the bridge did not fit, is it common to cut it apart to fit, or should it have been remade? Although I was told it would be welded back into one piece, it seems like a one-piece bridge is better than one that it welded. Can anyone help me with this? Thank you!
Answered by: Dr. Carlos Boudet West Palm Beach, FL
Website: http://boudetdds.com/
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Hi Irvin,
Some of the questions you ask concern treatment details that I cannot answer since I do not have any records or the benefit of having seen the work in progress in your mouth. However, I will try to do my best to help you.
When you say a full arch restoration I assume that you mean that all the teeth are splinted together. I further assume that you are referring to the upper jaw.
When you do a large bridge, the greater the number of units (teeth) the more likely that the metal framework will have some distortion from the fabrication methods introduced during impression taking, making of the stone casts, and waxing and casting the metal.
Some dentists and laboratories prefer to section the long span frameworks and index and solder them to make them as accurate as possible. Some prefer casting in one piece and take their chances on it fitting or having to section it after. Still other dentists prefer doing the work in sections in case one implant fails you don't loose the whole work, only that section.
So you see, there are different ways to do the work and what works best in my hands may not work best in the hands of my colleague down the street.
Don't be afraid to ask these questions to your dentist, but at the end, you need to trust the dentist doing the work to do things with your best interest in mind. If the trust is not there, you may not be satisfied with the result.
Good luck, and I hope this helps.
Carlos Boudet, DDS, DICOI
http://www.boudetdds.com
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