Tilted Implants in Resorbed Residual Bone

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Posted on By hemal shah In Implants

Maxilla with sever resorption, very soft bone, rotary expanders used at a speed of 35 rpm and implants placed . no threads exposed , contour augmentation with bio-oss collagen.
Mandibular arch sever resorption , mental foramen located and implants placed with normal drilling proctol as bone was highly corticated.
no plans for temporization

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good execution and interesting plan, few learning questions though... Why didnt you use longer implants on anterior maxilla ? Did you use a guide for placemnet of tilted maxillary implants ? the tilted implants in mandible really seem close to foraman, would you consider keeping them straight and using two more shorter implants (say 6-8 mm ) for the distal support ? probably easier to make to rehabilitate later too... I also loved the fact that you kept the posterior teeth should make the rest of the way much easier... tnx again for tough case it`s not easy to put ourselves out there...


Hi, thanks... The anterior maxillary implants are 12 mm and the tilted implants are 14mm . The entire case is free hand, no guided or any angulation tools used . I used the upper premolar sockets as my guide and planned the angulation. In the lower arch if we observe the scans the nerve doesn't loop ahead. So plan was to locate the mental foramen opening and start the angulation head on above it , to have as much of AP spread possible. We where working on a tight budget with this case so only 4 in lower , 6 would have been ideal. Since we plan to keep same prosthetic material in both arches , hence decided to go ahead with this plan..


How did you temporize the top to prevent undue pressure on the contour graft ?


There was no temporary planned for this case and patient was explained before hand the difficulties of giving a temporary prosthesis due to grafting involved in upper arch and thin tissue biotype in lower arch