Thanks in advance for reading- I really appreciate any input.

A new patient (let's call him Carlos) came to me this week asking what his options are to replace his flipper for tooth #8. He lost the tooth in February this year in an accident and had an all acrylic flipper made in April. When the flipper broke the following month in May, the same dentist made a new flipper, which also recently broke.

I am not positive about the design of the flipper because all Carlos brought in to me was basically the the pontic tooth with a little bit of pink acrylic remaining around it, but from what the patient described, it was an all acrylic flipper with some palatal coverage and retention with palatal gingival embrasures. Carlos says his dentist said it the patient's fault that the flipper keeps breaking and is offering to make a new one at full cost- a "flexible flipper that won't break" (per Carlos).

Carlos has flared maxillary incisors and a very deep bite, such that his lower incisors would occlude occlude on any palatal coverage acrylic. In my opinion, it was inevitable that his flipper would break, given his bite, but moving on....

Before everyone starts jumping on me about ortho and implants and Maryland bridges, all of which I have considered and discussed with this patient, let me tell you that he is only 17 years-old and finances are extremely limiting. I am already planning on giving him a very steep discount on his treatment and I don't think ortho or implants are in the cards for him anytime soon (complicated family background).

Other pertinent info that is not shown in the photos: He has a fairly low smile line and shows minimal gingiva on his maxillary anteriors.

By the way, this patient walked in to the office at the end of the day- my assistant had already left for the day and my front desk was practically out the door, so please forgive these awful photos- I just wanted to have something to refer back to.

I obviously need a metal framework, but do you have any suggestions on flipper design and materials for Carlos?

Thank you for your help! Becky

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