Gibbs Dentistry
Kenneth W. Gibbs, DMD, PA | Meridith Gibbs, DMD | M. Breckenridge Gibbs, DMD
June 6, 2023
Mr. George Bradbury
1808 Mission Falls Way Wendell, NC 27591
Dear Mr. Bradbury,
I have spoken with Dr. Gragg and he has a very good plan to repair/restore your maxillary arch. This will be my final response to your situation. You requested that I call you regarding your upper hybrid breakdown, which I did. You then became very contentious when I did return your call, especially since you have had no contact with our office in 17 years.
You were referred to me by Dr. Ed Mills in Atlanta, who, over a period of time placed eleven implants in your upper arch and four implants in your lower arch.
I examined you on 11/19/2004, and we discussed the restorative care that we could provide. Evidently, you had a previous relationship with Dr. Jaime Feinzaig in Costa Rica because the very next day, 11/20/2004, we received a fax from him describing the size, locations and a request from Dr. Mills to construct a cemented hybrid or have a removable daily restoration which you did not want since you were in a removable denture.
In 2004-2005 we did not have the ability to digitally fabricate screw down prosthetics like today. There was no milling of PMMA (acrylic) or milling of state of the art Zirconia. Your upper arch was constructed as a fabricated acrylic denture bonded to precious metal in analog construction. At that time we could not get Zimmer abutments, even angled ones, all of which were back ordered for up to 6 weeks. Root Lab did a great job in fabricating custom abutments and the substructure for your hybrid. Also, according to your time frame, you had to return to Costa Rica on 3/28/2005. From 11/9/2004 to 3/25/2005 we fabricated:
901 Pine Tree Drive | New Bern, NC 28562 | Tel. (252) 633-5544 | Fax: (252) 633-9788 | www.gibbsdentistry.com
* A new upper denture which was a copy of your existing denture;
4 porcelain fused to metal implant crowns cemented on Zimmer standard abutments; and
* A lab processed acrylic hybrid to metal to soften your strong lower bite This hybrid was cemented with a thin temporary cement which would make it easy to remove to make any repairs and provide maintenance to the implants. This was the standard of care 18 years ago. On 3/25/2005, 8/18/2005 and 12/1/2005 we recommended removal of the hybrid every two years.
May 24, 2006, at a preventive maintenance visit with our hygiene department was the last contact you had with our office. Living in Pine Knoll Shores, NC at that time, it would have made sense to see us if you were having issues with your upper hybrid. I could have easily removed it and with our lab here, make any repairs at no expense.
You mentioned that the restoration had never been taken off but, on 9/12/2008, a Dr. Gomez in Costa Rica called our office requesting the brand of cement we used to secure the hybrid, since it had come off twice under his care. This is a factual note in your chart. During this time, I would have been glad to help you had you been available.
Hopefully, Dr. Gragg can remove the hybrid and convert the situation to a 3D printed PMAA or a milled Zirconia restoration. Your fees in 2004 for a duplicated upper denture, a processed acrylic hybrid to metal restoration, four porcelain fused to metal implant crowns and 15 Zimmer abutments was $16,455 over 18 years ago.
Best Wishes,
Kenneth W. Bebbe, DMD, PA
Kenneth W. Gibbs, DMD
Cc: Dr. Anthony Gragg
Enclosure
FROM: CLINTCA ODONT. DR. FEINZAIG
PHONE NO.: 231 2667
Nov. 20 2004 12:00AM P1
Fez a
Clinica Odontológica Feinzaig S.A. De Mc Donald's La Sabana 75 Sur. San José, Costa Rica Tel. (506) 231-2866/67 Apartado 1271-1000
Dr. Kenneth Gibbs
San José, November 19th, 2004.
Dear Dr. Gibbs:
The following are all the implants that patient George Bradbury has. The implants were placed by Dr. Edward Miles in Atlanta, Georgia, they are ZEMER brand and the size and diameter are as indicated.
Tooth number
Size
Diameter
12
B = = x 10 + t
15mm x
6
:6rami &
13mmx
4.7
inn x
3.7
13min x
3.7
1.3 x
3.7
13mm x
3.7
3."
imm x
4.7
10mm x
4.7
13
smm x
6
19
13mm x
3.7
20
13mm x
3.7
21
13: x
31
13 N
3.7
4.7
According to Dr. Miles he recommends a cemented hybrid prosthetics or two individual bars with removable prosthesis. Also Dr Miles requested the upper left implants not be restored before January February 2005.
Good Luck
Jaime Feinzaig. D.D.S, M.S.
Dr. Gibbs.
FACTS;
I only became contentious when your office said I have to be a new patient AND you were not taking new patients.
Dr. Jamie Feinziag never did any work on my teeth. He asked you what you used to secure my teeth.
You have previously admitted to others that you permanently cemented my teeth in. Now you say "cemented with a thin cement". But you don't say a date or produce a copy of the record showing that procedure.
Your quote of Dr. Gomez "is a factual note in my chart". But you d read more
