Andrew's bridge system: A boon for huge ridge defect in aesthetic zone

Abstract

Tooth loss may pose a challenge for prosthetics when several missing teeth are associated with huge vertical and horizontal bone defects due to cleft palate, road traffic accidents, congenital defects etc.This case report presents prosthetic rehabilitation of a 22 year old male patient of cleft lip and palate with missing upper front teeth along with severe ridge defect since 1 year due to surgical intervention in premaxillary region. The extensive soft and hard tissue defect in aesthetic region was evident and it made the prosthetic rehabilitation more challenging. Among treatment options, fixed partial denture (FPD) was not feasible due to long edentulous span and extensive soft and hard tissue loss. Psychologically, patient was not ready for removable prosthesis. Patient was also not ready for next implant or bone augmentation surgery procedure. The patient presented with Kennedy class IV edentulous area with Seibert's class III ridge defect, so fixed-removable prosthesis was planned to compensate soft and hard tissue defect. The patient with several missing teeth and extensive visible bony defect in the anterior region was successfully rehabilitated using fixed-removable Andrew's bridge system. Although it is not commonly used by dentist so this present case report shows effective management of huge defect case by very simple and conservative technique.