Three or Four Implants in Lower Right Quadrants?
Fifty-nine year old lady requests restoring the lower right quadrant (Fig.1). There are multiple missing teeth: #2, 10, one of lower incisors and #27-31. Upper and lower midlines do not coincide (arrows). It appears that there is room to place 4 implants (#27-30 in Fig.1).
Her ridge is atrophic in the lower right quadrant (Fig.2). Initial wax-up shows that there is room for 3 relatively large teeth (Fig.3).
Fig.4-6 are CT coronal sections through the teeth #27,29, and 30, respectively. Implants are placed with bone expansion.
Fig.7 is a sagittal section. The diameter of the implant for #27 is 4.0 mm, those for #29 and 30 are 4.5 mm. It appears that there is still room for a fourth implant for the quadrant.
Xin Wei, DDS, PhD, MS 1st edition 09/01/2011, last revision 09/01/2011