Prosthodontics & Occlusion · patient case question
What is the most appropriate way to address her chief complaint?
Patient case: “I need some teeth here”
Patient: Female, 45 years old
Chief Complaint: “I need some teeth here.”
Background: Healthy, no medications, non-smoker. Teeth #19 and #20 were extracted more than ten years ago and never replaced. She has no pain and has never noticed a swelling.
Vital Signs: BP 118/76 mmHg · HR 70 bpm
Findings: The posterior left mandibular ridge is edentulous, firm and of normal contour with no expansion. In that edentulous bone the panoramic radiograph shows a well-defined lesion roughly 1.5 cm across, mixed radiolucent and radiopaque, with a thin radiolucent rim. The adjacent teeth are caries-free and respond normally to cold. The lesion was not present on a radiograph she brought from another office some years ago in the same location, which showed a lucency there.
Show answer and explanation
Correct answer: C. A removable partial denture
- A. Grafting means a second surgical insult to the same compromised bone, compounding rather than avoiding the problem. It does not make dysplastic bone behave normally.
- B. A wider fixture increases the volume of dysplastic bone violated and the surface area exposed to contamination. Primary stability is not the limiting factor here — vascularity is.
- C. CORRECT. The lesion itself needs nothing but observation, and her complaint is missing teeth. A REMOVABLE PARTIAL DENTURE restores function without entering the dysplastic bone at all, which is the whole objective. A conventional fixed partial denture is a defensible alternative where the abutments are suitable, for the same reason — it avoids surgery in the affected site.
- D. Observation is correct for the LESION, but it does not answer the patient. She presented specifically to have the missing teeth replaced, and there is a way to do that safely.
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