This was really kind of interesting...

The patient came to me through my Website. He was from Germany and just here long enough to treat his maxillary arch. He was in his mid fifties with no medical problems, but he is a very big man... He did have an impacted wisdom tooth in the left maxillary quadrant.

I would normally make him an immediate denture and let everything heal for six weeks, but time constrains what they were, I opted to do everything at once. The extractions were very simple and I started placing implants in the maxillary left quadrant with no problem.

However, when I started the maxillary right section, I saw a shiny white area that looked very much like a tooth in the central incisor socket! This turned out to be an impacted cuspid which I did not see on the original panorex. The patient had no idea he had this impacted cuspid which I removed and then placed my three implants in that side.

You can see from the post-op how dense this bone in the anterior region was. I can barely make out one of my implants (there are 6). I used a membrane and a tack to fill in the defect. The final restoration is slated as a bar overdenture.