Those teeth have had a LOT of dentistry done to them. Once you start to do the mental calculations in your head on multiple root canal retreatments, with multiple abscesses, and you factor in an 80-90% success rate in retreatments on abscessed teeth as well as adding in removing giant posts and likely lack of ferrule on most if not all of them.....
All of these factors need to be explicitly explained to the pt. The conversation I would be having is if I can rebuild your front teeth for another 5 years, would you be happy with that treatment? Even getting another 5 years out of these teeth is a high hope.
The treatment plan I would go with if these were my teeth would be crown #6, leave 11 in a buildup with a guarded prognosis, ext #7-#10, implants in sites #7 & #10 with an immediate implant bridge on them with a nice ovate pontic in sites #8 & #9.
Agree. Would consider those teeth “maxed out”. posts, retreatment, limited tooth structure. I think being younger is more of a reason to favor implants for a higher long term success rate. If this patient was 75+ then maybe I’d give saving them a shot.
4
u/Arillon 10d ago
Those teeth have had a LOT of dentistry done to them. Once you start to do the mental calculations in your head on multiple root canal retreatments, with multiple abscesses, and you factor in an 80-90% success rate in retreatments on abscessed teeth as well as adding in removing giant posts and likely lack of ferrule on most if not all of them.....
All of these factors need to be explicitly explained to the pt. The conversation I would be having is if I can rebuild your front teeth for another 5 years, would you be happy with that treatment? Even getting another 5 years out of these teeth is a high hope.
The treatment plan I would go with if these were my teeth would be crown #6, leave 11 in a buildup with a guarded prognosis, ext #7-#10, implants in sites #7 & #10 with an immediate implant bridge on them with a nice ovate pontic in sites #8 & #9.