Immediate Provisional Bridge

A 52-year-old lady has lost totally 5 lower posterior teeth (2 on the right, 3 on the left (#18-20, Fig.1 (CBCT sagittal section)).  Fig.2-5 are coronal sections of the individual edentulous areas.  It appears that the cortex is thick and dense, whereas the cancellous bone is loose (50-300 Housfield units).  To obtain higher primary stability without microfacturing the cortical plate, use one size smaller drill for the cancellous bone (Fig.5 white line, as compared to Fig.4 green line); the last drill barely touches the coronal portion of the osteotomy (Fig.5 red line).  If primary stability is too high, a profile or tap drill can be used from UF cassette.

If primary stability of these 3 implants is reasonable, an immediate provisional bridge will be fabricated after abutment placement.

Since the tooth #15 is supraerupted, the implant at #18 needs to be placed a little deeper than designed so that there is enough space for restoration.  A surgical stent has been fabricated.

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Xin Wei, DDS, PhD, MS 1st edition 08/16/2015, last revision 09/16/2015