Patient previously had a fixed bridge from #6–10, supported by natural abutments #6, #9, and #10. Tooth #10 had prior endodontic treatment and has now fractured at the gingival margin. The bridge cannot retain adequately when supported only by #6 and #9.
Would it be feasible to place a new implant at #10, secure the prosthesis with a screw‑retained connection on the #10 implant, and cement the bridge on abutments #6 and #9?
Are there alternative treatment plans to consider? Thanks!
conventional bridge #6-#11 just like we used to do before the epidemic of titanium toxicity…
dr scotty’s advice sounds sarcastic 
but i think there’s truth to dr scotty’s advice. From the pano, site #7,8 have a huge boney defect, and you should remove #9,10. Perhaps doing a #5-12 fixed bridge would be a better choice. The hail mary would be GBR/implant/fixed bridge which would involve a huge vertical/horizontal GBR from #7-10. which will take 6-9 months. during healing pt cannot use removable so, you still gotta do a #6-11 PMMA temp while patient is healing. after bone consolidates, 2 implant bridge #7-10 would take another 4-5 months to finish. the lower hanging fruit would be a native teeth fixed bridge or a RPD w/o GBR/implants.
If you want to keep #9. just do a #6-9-11 bridge. That’s fine also. Really no need to do a #10 implant/crown.
good luck.
the problem with conventional tooth supported bridge is as the abutment tooth fails the bridge become longer and other healthy teeth are forced to support a longer bridge and subject to more occlusal forces and trauma, eg 3 teeth are forced to support occlusal forces of >5 teeth until you run out of healthy teeth then fixed bridges get converted into a RPD and eventually to a complete denture.
