Orthotown January/February 2020 - 18
message board
Patient Missing U1s, Getting
Close to Implant Age
Townies consider how to give a patient the best prep going into a much-needed implant case
dhmjdds
Member Since: 11/16/04
Post: 1 of 6
17-year-old girl with U1s avulsed in a pool accident at age 8. Has had multiple well-made,
well-fitting flippers over the years.
Mild Class III skeletal, low angle, reduced lower facial height. Class I dental.
I think there is not enough vertical clearance for implants and crowns, and probably she
will need a ridge augmentation first, so that problem is worsened. I also think the lower incisors
are too far forward relative to the ridge, so getting the proper emergence profile and inclination
would be difficult or impossible.
My thoughts are to extract a lower incisor to allow significant retraction of the lower incisors,
and to do a lot of lower incisor intrusion. Those two things will be difficult to do at the same
time. I am of course contacting the restorative dentist (who also places implants) to get his input
and desires for this occlusion.
If any of you are more experienced with implant site preparation, or if you just have additional
thoughts about this case, I would love to hear your input. ■
12/19/2019
emac
Member Since: 11/21/11
Post: 2 of 6
It appears you have had some supereruption of the lower incisors. If you could intrude and
retract them a bit, it may be enough. I would have a prostho look it over and get their opinion as
to how they want to restore it. I wouldn't feel comfy making their decisions for them. Let them
drive the case. Just my quick thoughts. Fun case, thanks for posting it. ■
12/19/2019
18
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