Solutions to Narrow Ridge

A 49-year-old lady seeks treatment after loss of a lower left bridge (Fig.1-4) (apparently cantilever one (Fig.11)).  Reconstruction of the lower right sextant requires orthodontic intrusion (1,2) of the upper right molars (Fig.2).  It appears that it is quicker to restore the lower left sextant (Fig.3,4).  How to handle the narrow ridge?

At the site of #20, a 1-piece implant (3 mm) will be used (Fig.5,6 CT coronal sections): apparently the shorter one (10 mm) is safer than 12 mm one.

For the narrow ridge at the site of #19 (Fig.7), the coronal exposed threads of the 5x12 mm implant will be bone grafted (Fig.8 red circles).

The implant at the site of #18 could be placed at the crestal level with bone graft (Fig.9: 5x10 mm).  Or a shorter implant is placed deeper with or without grafting (Fig.10: 5.3x8 mm).

Collagen dressing is cut to shape of the edentulous area of the model.  The sockets of #19 and 20 appear not completely ossified (Fig.11: CT sagittal section).  The teeth were extracted approximately 6 months.

The design of the lower right implants should be concentrated upon the length of osteotomy.

Return to Lower Arch Reconstruction Xin Wei, DDS, PhD, MS 1st edition 05/27/2015, last revision 05/29/2018