Andrews bridge revisited: A new custom cast ribbed bar and sleeve design fixed removable partial denture

The loss of teeth invariably is followed by the loss of soft tissue. There is a high incidence (91%) of residual ridge deformity following anterior tooth loss reported in literature; the majority of these are Class III defects that require soft-tissue surgery to augment the ridge defects. Esthetic surgical replacement is difficult and unpredictable, particularly when papilla in the esthetic zone needs to be restored. One choice is a fixed removable prosthesis retained by an Andrews bar and sleeve system. The prosthesis is designed to meet the requirements for esthetics, comfort, phonetics, hygiene, and favorable stress distribution to the abutment and soft tissues. One of the major advantages of an Andrews's bridge over fixed prosthesis is that it can be removed by the patient for improved oral hygiene access. This article describes the procedure for fabricating a new custom cast “ribbed” bar and sleeve design Andrews bridge.