Limited Interproximal Space for Cement Retained Crown
Posted on 08/03/2011
Devising long term restorative solutions for patient with edentulous narrow spaces (for example, congenital missing laterals or tooth crowding a missing bicuspid) can be quite challenging. Standard implants- perhaps the ideal restorative treatment plan - require sufficient space to contour the crown to match the parallel tooth. Mini implants are a viable alternative. The only major drawback to the mini implant is that custom abutments are not usually an option and the mini implant abutments are typically quite small and may not provide sufficient support for the final crown.
In a recent case, the doctor placed a 3.5mm narrow Nobel Replace Select implant. The initial request was for a custom abutment with cement retained crown. We had no space to make the two as separate pieces, so we offered the option of a screw retained crown with metal mesial and distal contacts. Although the doctor was concerned about the metal contacts, the alternative - reducing the adjacent teeth each by 0.5mm, was less appealing.
The doctor agreed to the recommendation but will wait for the patient to approve it in the mouth.
This type of case really has limited options. Any other suggestions would be quite welcome.
In a recent case, the doctor placed a 3.5mm narrow Nobel Replace Select implant. The initial request was for a custom abutment with cement retained crown. We had no space to make the two as separate pieces, so we offered the option of a screw retained crown with metal mesial and distal contacts. Although the doctor was concerned about the metal contacts, the alternative - reducing the adjacent teeth each by 0.5mm, was less appealing.
The doctor agreed to the recommendation but will wait for the patient to approve it in the mouth.
This type of case really has limited options. Any other suggestions would be quite welcome.
