Preparation for Anchorages in Lower Left Quadrant

Two implants are to be placed at the sites of #20 and 21 (Fig.1 CT sagittal section) to be used as ortho anchorages.  When paralleling pins (Fig.2 P) are inserted, they happen to be in the original sockets (arrowheads).  Two 4.5x11 mm implants are also placed more or less in the original sockets (Fig.3).  Postop X-ray is shown.

Two separate provisional crowns are to be fabricated with the occlusal table of #20 being lower, since #13 has mobility and has supraerupted. Leave a space (1-2 mm) mesial to #21 provisional so that the tooth #22 and 23 can be moved distally.  A premolar band is going to be placed at #21.

There is no bone loss 2.5 years post cementation (Fig.4). 

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Xin Wei, DDS, PhD, MS 1st edition 10/04/2014, last revision 11/26/2017