Prosthodontics & Occlusion · patient case question
What is the FIRST step in management?
Patient case: Loose anterior bridge with an open margin
Patient: 58-year-old woman.
Chief complaint: My bridge is loose and I can see metal at the gumline.
History: Bridge placed roughly ten years ago spanning the maxillary right canine to the maxillary left lateral incisor.
Findings: Visible open margin with exposed metal on the canine retainer, described as an over-contoured and poorly finished preparation margin. Caries at the canine margin. The prosthesis moves under load.
Show answer and explanation
Correct answer: C. Remove the bridge
- A. Recementing over active caries seals bacteria against the abutment and guarantees progression to pulpal involvement.
- B. Occlusal adjustment addresses none of the three problems present.
- C. CORRECT. A loose prosthesis with an open margin and caries beneath it must come off before anything can be assessed. Only with the bridge removed can the extent of caries, the remaining tooth structure, and the restorability of the abutments be judged.
- D. The caries is subgingival at a retainer margin; it cannot be adequately accessed or sealed with the bridge in place.
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