This patient came to my office having lost her lower bridge. Clinical and radiographic exam shows generalized recurrent decay, inflamed gingival tissues and other pathologies. I was surprised that she was in the process of implant therapy in her native city of Paris. Though implant therapy is an effective means of restoring a lost dentition it is important to eliminate infection prior to these procedures. Failure to do so could jeopardize the success of the implants. A proper treatment plan in her case would have been to eliminate all defective restorations, inflammation and decay as an initial step . Properly fabricated temporary restorations would allow the patient to regain function and eliminate the time and expense of emergency visits.

In regards to the current implant therapy, it appears that the upper right implants are placed too close together. This precludes effective hygiene access which could result in chronic inflammatory tissues and bone resorption.                                                                                                                                                                                                                             The lower right mesial implant has been placed adjacent to a deteriorated/decayed tooth root thereby establishing an unhealthy microbiologic environment. A bone graft appears well integrated within the upper left maxillary sinus, however restoring this edentulous area prior to eliminating generalized infection is again contraindicated.