bridge repair

pt came in with a 6 units bridge on #2-6. Abutments were #2,4,6, all serviceable except for a open margin on #6F. Previous history of treated periodontal disease, moderate to severe recession, but undercontrol with excellent oral hygiene.

pt had seen other dentist who suggested to have the bridge replaced, or sectioned with implants done on the missing teeth area. pt was very reluctant. Ridge was very atrophic, and quite a lot of bone graft would be needed.

I felt it was a very minor open margin considering how long was the bridge, and offered an alternative. Removing the decay and explore how deep it was. Fortunately, there was not a lot of decay under the metal.

I

 I beveled the porcelain, etched root surface, etched porcelain with hydrofluoric acid ( ultradent) and silane applied. primer on tooth surface, bonding agent on both, composite ( opaque first to mask the metal and match the opacity of the PFM abutment), finished and polished.

This was immediately post-op, after retraction cord removal.

This was taken in 2010, 5 years later  I saw him during recall this year, and it still looks pretty good.

Just some ideas for alternative treatment. I think this was the most conservative option we had. Both of us were very happy about the results.