You saw this 55-year-old patient in my last blog, so you know that she has a deteriorating joint on the left side as well as severely periodontally involved teeth under the existing bridge. We know that the joint may not be stable and that we need to make sure the patient knows this before we do any treatment and that she is aware that some bite changes will most likely occur. Now to the questions in this blog. All of the abutments under the bridge will be lost as well as the upper right third molar. The only salvageable teeth are the upper right premolars, canine and lateral. Structurally, the lower arch is intact; she may lose the lower left second molar, and the implant in the right lateral position may need to be replaced. So the question is, what is your best solution for this patient? Do we keep every tooth we can or find an alternative? How would you guide her? If you keep the remaining upper teeth what are the considerations? This patient wants the best esthetic result possible. She says she has had âpatchwork, I donât want that anymore!â Throw out your ideas and letâs see where it takes us.