The patient is a healthy 46-year-old woman. She attended the consultation with pain and a fistula on the first right incisor. She also complained about her smile aesthetics. She wanted to laugh freely with out being ashamed, and to exchange the top removable plate for a fixed solution.
The patient had an active apical infection on tooth #11 (8) and the complementary exams showed a lack of the buccal bone plate in the socket. There was also a submerged root of the left canine #23 (11) with apical infection and a very damaged first, left premolar with apical problems. The remaining 5 maxillary teeth had poor aesthetics with old repeated treatments.
Maxillary planning includes pre antibiotic therapy for one week, after which all of the remaining teeth are extracted. Immediate maxillary All-on-4 with socket and cyst cavity bone grafting and immediate load with a temporary hybrid protheses.
Planning for the mandible included extraction of the damaged and poorly positioned premolar and 1st molar on the left side, with an immediate implant and single implant with an immediate Locator abutment on the right side to help stabilize the new immediate inferior removable protheses.
6 months later, a new final hybrid prothesis will be done on the maxilla and the left mandibular implant will be placed.
