Guide Prior to Intrusion

A 58-year-old man has lost the teeth #18 and 31 with supraeruption of the opposing teeth and mesial tilt of the distal tooth (Fig.1,2 arrows).  Since the supraeruption is less severe on the right side (due to the presence of the tooth #32 as an antagonist to supraeruption of the tooth #2 (Fig.1' (arrow), as compared to Fig.2')), an implant will be placed at #31 with guide first (Fig.3 (coronal section of CT)).  It is pity not to ask the lab to place the implant slightly distal for #32 upright.  It is important to take impression for precise analysis of localized malocclusion.   Intrusion of #2,15 will be initiated at the same time (Fig.4,5 (axial sections)), while the implant placement at #18 will be done last (Fig.6).

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Xin Wei, DDS, PhD, MS 1st edition 05/14/2018, last revision 04/20/2020