Treatment Planning For Future Implant Cases

January 12, 2018 Lee Ann Brady DMD

Approaching implant reconstruction as an all or nothing situation ignores the reality of future patient needs. Often it is too expensive for patients, who will not be able to proceed fully with treatment. They then receive only part of the complete treatment plan.

For example, with an edentulous arch the difference between a lower denture with two implants and locators as opposed to five implants with a fixed restoration is significant.  Alternately, it’s common for patients with two implants and a lower denture with locators to be dissatisfied with their function and esthetics. They may wish to move to a fixed restoration if they can now afford it. But does the clinical situation make this possible?

Implant Treatment Planning for the Future

It’s a good idea to create a treatment plan for a patient that doesn’t eliminate their ability to select different treatment in the future that could lead to improved esthetics, health or function. Certain planning decisions must be applied when placing implants to ensure necessary spacing and vertical room for a fixed restoration.

Ideally, the plan would include fixe fixtures between the mental foramina for a fixed restoration. If the patient currently wants a removable with two implants, the ideal placement can be planned for five. The 2 and 4 spots can then be used for placement of fixtures with locators.

This gives enough room for three potential implants later on that are spaced correctly. Though the placement choice can be based on a clinician’s preference for where locators would be, the 1 and 5 locations allow for ideal placement of five future fixtures. Still, many patients will have two fixtures between the mental foramina that negatively impact proper spacing for a fixed restoration. On top of this, the lower ridge position is another important factor to consider. It must be managed to account for vertical space.

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About Author

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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