19 y.o male presents with maryland bridge replacing #8. History of Dens en dente on #9 and #10. #10 was successfully treated endodontically, #9 wasn't able to be treated and was extracted 4 years ago by another office and placed into Maryland Bridge. MHX and Soc Hx unremarkable.
Thin Biotype and High Smile Line. PD WNL. Good OH.
Will post PA and CBCT later, but adjacent bone levels perfect. #10 restored with crown.
Horizontal defect on facial, will have to wait on CBCT to see if bone augmentation needed. Definitely CTG, either free graft or pedicle roll technique.
The question is.....
1) Place as 2 stage with CTG and temporization at uncovery? Replace Maryland FOD during healing.
2) Place as 2 stage with CTG at fixture placement, temporization and possible additional roll at uncovery? Replace Maryland FPD during healing.
3) Place as 1 stage with CTG and immediate, non-loaded provisional. (Not my preference)
4) Place as 1 stage with CTG and healing abutment. Replace Maryland Bridge.
Any other thoughts would be welcome also.