Ridge Reduction

A 71-year-old man has lost an implant at #29 (Fig.1 (taken 3 years earlier)).  CT shows that the implant at #30 is failing.  The biggest challenge of re-placing implants at the lower right is lack of keratinized gingiva.  Gingival graft is mandatory. 

The abutment tooth at #18 is symptomatic with gingival recession (Fig.2).  It appears that it is overloaded due to pressure from the tooth #14 (Fig.1 arrow).  An implant at #19 should be able to alleviate the pressure on the tooth #18.

The 3-unit bridge (#18-20 in Fig.1) will be sectioned (Fig.2 red lines) with the pontic of #19 to be removed.  The ridge top is narrow (Fig.3).  To place a 5 mm UF implant, the triangular ridge top should be reduced (result). 

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Xin Wei, DDS, PhD, MS 1st edition 04/16/2016, last revision 01/19/2018