I know that there is a lot of push for immediate implants and immediate provisionalization for cases with terminal dentition. All on four can be a predictable treatment option for some cases. But there are some cases where the prosthetic references are lost and the teeth are so unstable and unreliable for both the analog and digital records, they need to be managed with a set of transitional dentures before implants can be planned and placed.
For some patients, the terminal dentition can be so unstable that even making immediate dentures was a feat in itself. This was a case where I tried to get the patient some teeth so she would not have to go toothless after the extractions. It took some considerable efforts in thinking and planning….in the end the outcome was still not quite ideal but I was able to correct the errors by relining the dentures.
I hope this case offers people some insights to understand the inherent errors that can exist when designing immediate prosthesis on a terminal dentition, especially on cases where the teeth are so unstable to obtain predictable records. Despite all the challenges, we find solutions to make things work. Thanks for taking a look!
