DIAGNOSTIC WAX UP 17.0mm 5.5mm Interocc space=10mm Open bite=4mm Central incisaa gingival=12mm Mesial-distal=8.5mm

Close up x-ray of Rx area

Periodontal condition showed Severe Chronic periodontitis(bone loss) with attachment loss Horizontal and vertical bone loss With splaying of #9 labially 4mm Extrusion in relation to adjacent teeth 6mm recession +3 mobility Pocket depth was labially and lingually 12mm STAGE 1 ENDOSSEOUS IMPLANT PLACED 3.7X13 ZIMMER MTX Gary F. Tunier DMD

After extraction was performed on #9 I reviewed the socket walls carefully for any dehiscence or fenestrations along the facial wall. It is wise to pay particular attention to the granulation tissue apically. It seems that the saucerization area was tricky since the granulation tissue that remained there was hard to detect until I continued to use a molt 2/4 to debride that area. THE IMPLANT FIXTURE IS APPROX. 4MM FROM THE IMPLANT PLATFORM TO GINGIVAL MARGIN SINCE THE HEALING ABUTMENT IS 5MM AND SHOWS ABOVE THE GINGIVA 11.85MM 13 MM Gary F. Tunier DMD

I PERFORMED THE OSTEOTOMY APRROX 5MM ABOVE THE BASE OF SOCKET AND ON PALATTAL WALL Gary F. Tunier DMD

PREOP AND POST OP XRAY OF SITE # mm 2.65mm 5.5mm 3.7x13mm zimmer MTX ROOT APEX OF #8 Gary F. Tunier DMD NOTE EXTENT OF BONE LOSS

THE PFM CROWN HEIGHT WILL HAVE TO BE APPROX. 12MM FROM IMPLANT ABUTMENT MARGIN TO INCISAL CROWN HEIGHT INCISAL-CERVICAL

Intra Oral Views

PRE-OP-NOTE EXTRUSION OF #9 POST OP WITH PROVISIONAL AND HEALING ABUTMENT 5X5MM Gary F. Tunier DMD

ACRYLLIC PROVISIONAL FABRICATED ON TOP OF HEALING ABUTMENT

LATERAL VIEW OF PROVISIONAL OF #9

The End