SINGLE-TOOTH

REPLACEMENT:
TREATMENT OPTIONS

Rola Shadid, BDS, MSc, Associate Prof., American Board

of Oral Implantology, Fellow AAID
Lecture Outline

▪ Posterior Single-Tooth Replacement

Options
▪ Maxillary Anterior Missing Tooth
Treatment Options
▪ Diagnostic criteria for esthetic risk
assessment
▪ Proper 3-dimensional implant
positioning
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Posterior Single-Tooth Replacement Options

used as transitional restoration

transitional restoration in the casesofmissingsingle posterior
booth because it has high debounding rate
when I Seled not to replace

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Posterior Single-Tooth Replacement Options

When m select not to replace as

a validsituation

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 Maintenance of the Posterior Space

▪ Small intratooth space (< 6 mm) verydifficult

to clean under
▪ When the reduced amount of the ponite

intratooth space should be closed,

orthodontics or overcontoured
crown(s) on adjacent teeth may
correct the condition.
extracted lower6 teethdriftinghasbeen
decreased
occurred so the space was
could notreplacedand
very small tiny space
thiswould not affect theocclusalstability
periostatus or even endostatus

E i.rroaems
17
t.EE
in this case the bite is maintained
super eruption and will not take place
tilting
will
but food accumulation plaque and caries
occur in this area if the patient dosen't
clean it Probably So I should tell

he she that this area cleansing is

mandatory

if Patient want to close it what to do

ortho treatment
1 or close the space by
Off
Create 6.5 7 mm space

2 two overcontoured crowns at the

adjacentteeth separate crowns
have very good cleansability by floss

3 composite restoration more conservative than crowns

don't prefer it in
Cantilever bridge can be done but
we

the posterior teeth

 Maintenance of the Posterior Space

When the third molar and second molar are

the only posterior mandibular teeth missing

mandibular second molar is often not replaced

To prevent supereruption
S fizzing.ÉÉept
Icouldchoosenot to
without replacinglower
I retainer small wire
replacewithout 2 if 6 7 nyeeds crowning
consequences
any
benefits
make 2 splinted crowns
risks 3 if the lower 6 needs
How much functionv11
crown extend it distally
gainfromreplacing to make
Lower2ndmolar a stopPoint
with the mesial part of
lessthan 5 the
upper 7
a implant 18
 surgical risks
de endangeringthe

prostheticrisks

21 5 1
T.IE is

lingualplate
retainedcrown Perforationwill
happen life
L 3 threatening
hemorrhage
so I shouldplace
In king
on theimplant is
produced
3 atthis areabuccinal

4 limitedsurgical
accessibility 19
Disadvantages extrusion & loss of the maxillary second molar
of not
replace loss of proper interproximal contact with
adjacent tooth
Mand. 2nd
molar
increased risk of caries, periodontal disease,
or both

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To prevent extrusion of maxillary second molar

crown on mand. 1st molar include an occlusal contact

with mesial marginal ridge of max. 2nd molar

maxillary 2nd molar bonded to maxillary 1st

molar

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When should replace mand. 2nd molar?

When the third molar is in function

Pt’s desire
Extreme force factors (brachycephalic facial type)
When 1st molar is also missing

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 when I should replace lower 7
informed about the risks
1 Patient want to replace it but he MUST

2 when the patient has the 8 6 in a good state

avoid the risksand tell thepatient about them

So when the 8 is present select to replace

3 Patient with extreme force factor it's recommend to replace

and even the 8
like I burxism Parafunction activity
2 size patient_ M or F
large
3 Brachiocephalic facial pattern
short wide faces
low FMPangle

u when first molar is also missing

Better accessibility
A brachiocephalic skeletal patient has a greater
bite force than the average patient. This is
especially noteworthy when parafunction is
present.
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 Max. 2nd Molar sinus letting is required andit's a predictable
procedure with above 95 success rate

easy to be replaced
A missing max. 2nd molar
opposing mand. 2nd molar
with extrusion may result
in occlusal concern

As a general rule, maxillary

second molars are usually
replaced with an implant
when opposing a natural
tooth extrusion of thelower 7 into theupper 7 space

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cnn.name enniounsainweenny i ii EE i i i
Posterior Single-Tooth Replacement Option
Conclusion 8
Ed affhound
IMPLANT
eeth
ate en adf.ee

in

IMPLANT

D eesssurg.cat oisioit
DISADU

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 go

Fixed Partial Denture

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 Fixed Partial Denture

Goodacre. Clinical complications in fixed

prosthodontics. J Prosthet Dent 2003;90:31-4
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Fixed Partial Denture

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Posterior Single-Tooth Replacement Options

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