An Evidence Based Restoration of Esthetically Challenged Maxillary Anterior Arch with Andrews Bridge System - A Case Report with 5 Years of Follow Up

Manawar Ahmad,Dhanasekar Balakrishnan

doi:10.4172/2161-1122.1000357

Abstract

The replacement of missing teeth and restoration of alveolar contour has always presented a problem in those patients who have suffered traumatic injuries to the anterior dentition and alveolar processes. Many of these injuries lead to excessive loss of the residual ridge and make it extremely difficult to restore with a conventional fixed prosthesis. Due to constrain of fixed pontic in relation to these residual ridges, the use of this modality is virtually eliminated as a successful means of restoring such defects. An approach to the treatment in such patients has been conceived whereby a removable pontic section is supported directly by adjacent abutment teeth in a manner similar to that of fixed prosthesis. This case report represents restoration of esthetically compromised partially edentulous maxillary anterior arch with a fixed-removable prosthesis. This article also illustrates the indications, advantages, disadvantages and limitations of the Andrews bridge system.

Highlights

The fixed-removable partial denture, known as an Andrew’s bridge has a pontic assembly that is removed by the patient for preventive maintenance [1]
The fixed-removable prosthesis consists of a substructure designed for the specific contour of the residual ridge being treated and it is attached with the abutment castings
After 5 years patient was evaluated to access the success of treatment which was well adapted to the Andrew's bridge system (Figure 7)

Summary

Introduction

The fixed-removable partial denture, known as an Andrew’s bridge has a pontic assembly that is removed by the patient for preventive maintenance [1] Primary indications for this restoration are cases where the abutments are capable of supporting a fixed partial denture but the residual ridge has been partially lost due to trauma, congenital defects or other pathologic processes so that a conventional fixed partial denture would not adequately restore the patient’s missing teeth and supporting structures [1,2,3,4]. The condition of abutment teeth was evaluated and the treatment plan was to fabricate the fixedremovable prosthesis to restore this esthetically challenged maxillary edentulous region. The abutment teeth were prepared for ceramo-metal preparations with more reduction on the axial walls of abutments approximating the pontic to allow space for joining the supra-structure bar and metal retainer. After 5 years patient was evaluated to access the success of treatment which was well adapted to the Andrew's bridge system (Figure 7)

Discussion

Conclusion