The Insertion Appointment

This, more than anything, is an assessment of aesthetics {Fig 5-21) and occlusion (Figs 5-22 and 5-23) which represent the two most paramount concerns for satisfactory and functionally successful bridgework. All practitioners will be aware that if the clinically ideal bridge is considered by the patient to be unaes-thetic, then essentially from the patient's viewpoint, treatment has failed.

Fig 5-21 Assessment of aesthetics, though important to the clinician, Is the right of the patient. It is well worth remembering that a bridge that satisfies all criteria, except for patient satisfaction of aesthetics, is doomed to failure.

Fig 5-22 Light contact in centric should be assessed by means of Shimstock™ and articulating paper. It is important that all implant supported prostheses also demonstrate axial loading in centric, if possible.

Fig 5-23 An assessment of working side contacts should demonstrate a balanced distribution of load and excursive movements should always demonstrate canine guidance in the presence of a natural canine, or group funclion when the canine is incorporated into the implant restoration

Fig 5-24 A one year post insertion radiograph of this anterior implant retained double construction clearly demonstrates a propitious crestal bone level. In the absence of clinical signs, this would suggest a satisfactory bridge design, with favourable load distribution to the supporting implants.

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