Surgical crown and bridge prosthodontics

Abstract

A bilateral mandibular alveolectomy and the reduction in the gingivo-occlusal height of the opposing maxillary posterior teeth proved to be the solution for the problems associated with this case. However, such a treatment plan is not advocated for the vast majority of patients with similar situations. Before proceeding with any plan for the removal of mandibular bone, extreme caution should be exercised. This treatment was undertaken for this patient for the following reasons: 1. The patient's age was favorable. Neither a younger nor older patient would have been as favorable. 2. The alveolar bone present was in excellent condition presenting well-formed and well-positioned ridges. 3. There was no loss of normal vertical dimension. 4. Mandibular posterior soft tissues and alveolar bone were being traumatized, and would be lost in some degree under such conditions. 5. Careful examination of the roentgenographs and illustrations will reveal that the maxillary molar teeth were not extruded or elongated. If extrusion had occurred, the clinical crowns of these teeth would have been increased gingivo-occlusally with the resulting exposure of the necks of the teeth. Clinical examination failed to reveal any extrusion, but rather, it disclosed the fact that all the tissues in the entire maxillary molar regions had dropped en masse. Such a condition makes the reshaping of these maxillary teeth easier and more tolerable for the patient.