Anchorage
In addition to supraeruption of the teeth #2 and 3, the caries in the mesiobuccal root of #3 seems to be beyond salvation (Fig.1,2 arrowhead). When the implant at #3 is osteointegrated, a provisional restoration is placed (Fig.4 pink). Brackets (white boxes) are placed at differential levels among #1-3 to initiate regional orthodontic treatment using #3 as an anchorage. Mini-implants are placed if necessary. The tooth #1 is extracted after the limited ortho. Scaling & root planing will be done first.
Re-examination clinically and radiologically reveals that there is no caries involving the tooth #3 (Fig.5). It appears that CBCT may have artifact. Treatment planning for intrusion should be modified. Mini-implants will be employed after #2 DO composite. Prepare Anchor mini-implant kit, 2 of 10 mm and 1 of 8 mm mini-implants, anesthetics and #15 scalpel. Scaling & root planing will be performed.
Lower Full Arch Reconstruction
Xin Wei, DDS, PhD, MS 1st edition 06/04/2015, last revision 07/04/2015