[Diagnostic / Planning]  Chapter 2 : of 4 implants / locators

Sections enclosed re 43 and 46 region.  of same 50 yr old female .

. #43 - narrow ridge , locks buccal bone ;  Stability will be at apical  1/2 - 1/3 ; exposed threads to be grafted - aided by f-PRF , autogenous , allo, and NovaBone  mixture  ( over-kill ??)  Planning 3.5 x 11.5 fixture

  #46- planning 4.0 x 10 ml.  fixture .

Re- #36-- planning for 4.0 x 7.0 ml fixture .

 Note - lesions  will need thorough debridement . 

 Alternative would  be  GBR  as stage one .   All anterior sockets will receive PRF.

Any suggestions are welcome

Thanx .

by Madeson Basie at Thu, Jan 12, 2017 9:35 PM

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Ho-Young Chung Replied at Sat, Jan 14, 2017 9:37 PM

Hi Madeson,

Thank you for posting this case up for discussion.  I would like to add my two cents here as implant-retained overdentures is my favourite subject.

1) All full mouth cases whether removable or fixed require bone reduction.  This must be taken into account as you need room for your prosthetic components and the prosthesis itself.  In molar areas, this can mean your having to place a shorter implant or not being able to place an implant at all because of proximity to inferior alveolar nerve.  The 36 area for your patient based on your tracing of IAN will not allow for safe placement of an implant after appropriate bone reduction.  

2) I recommend having at least 1.5mm of bone (2mm would be best) on both buccal and lingual of implant.  If buccal plate is missing then there must exist at least 2mm (if not more) of potential graft envelope.  Even if you were to place 3.5mm implant at the canine areas, it will be difficult to regrow enough of the buccal plate as your graft will be out of the bony envelope.  

Ho-Young Chung