Preventing posterior collapse.

Categories ; Posterior, Nobel Biocare

85 year old male with failing dentition, create occlusal posterior contact before anterior tooth loss

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21/22 poor prognosis

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BLP placed ; screw access in estimated fossa, no wax up was made, casting material is Tak earth Stone, which does not need mixer or vibrator for fast in-office casts

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Free end situation requiring sufficient acrylic to create a non flexing stiff guide

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Guide in place

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Radiograph indicates no need for rotational adjustment, so use 0 degree green rotation block

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X-tip ( Tulsa Dental) intra osseous anesthetic ; very fast , deep, local anesthesia

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Crestal incision, without releasing incisions, to bring keratinized gingiva to the buccal

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23.7 -3-1.5 = 18.7 for 8.5 mm implant osteotomy. Red flexistop = 3 mm, green flexistop = 1.5 mm

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2.8 mm diameter at 8.5 mm

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18 â&#x20AC;&#x201C; 3 - 10 = 5 mm osteotomy at 3.8 mm diameter for stepped back prep for osteotomy of tapered implant.

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Depth verification

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Nobel Active Guided Tap

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Nobel Active guided tap

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Nobel Active 4.3 x 8.5 mm

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Seated at 70 N/cm

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Attached gingiva towards the buccal without releasing incisions

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Implant will give patient posterior support, when 22/21 are lost

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