09/05/2026
A male patient reported to our clinic with the complaint of a mobile bridge in the lower anterior region, which had been placed elsewhere approximately 2 years ago. The patient was experiencing difficulty in chewing along with slurred speech.
On clinical and radiographic examination, significant bone loss was observed in the mandibular anterior region, and the existing abutment teeth showed poor periodontal and bony support. After detailed discussion with the patient regarding the available treatment options — *removable prosthesis versus implant-supported prosthesis* — including the advantages and limitations of each, the patient opted for implant-supported rehabilitation.
A CBCT scan was advised to evaluate the exact bone condition and surrounding anatomical structures. Based on the CBCT findings, implant placement was planned in the 44, 42, 32, and 34 regions with careful consideration of vital anatomical landmarks including the mental foramen, lingual nerve, buccal nerve, and the existing bony defects.
To manage the compromised ridge anatomy, all implants were strategically submerged 4–5 mm below the knife-edge alveolar crest. Osteotomy preparation was performed using *Densah Burs*, which promote osseodensification rather than conventional bone cutting, making them an ideal choice for thin bony ridges and improved primary stability.
*BioHorizons conical implants* were placed, providing excellent implant-abutment stability and support. Multi-unit abutments were then connected — a 30° angled multi-unit abutment in the 44 region and straight regular multi-unit abutments in the remaining three implant sites.
The surgical flap was repositioned and sutured with precise, clean closure. Post-operative instructions were thoroughly explained, with special emphasis on smoking cessation and maintenance of proper oral hygiene, considering the patient’s history of chronic smoking.
The patient has been advised for follow-up after 3 days.
Wishing the patient a smooth healing phase and successful rehabilitation ahead. 🦷✨
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