I am planning on extracting the mandibular right central and lateral incisors and the mandibular left lateral incisor and installing BioHorizon 3.4x9mm implants. Most of the mandibular anterior, teeth from canine to canine, have advanced periodontal disease. I am planning on extracting the ones that are most affected by periodontal disease and have Grade 3 mobility. I suggested extracting all the mandibular anterior teeth and placing 2 implant in the canine sites but this was not accepted by the patient. The buccolingual bone width at the implant sites is 4.4mm. I believe I will need to do bone grafts at the sites. Which would be the better treatment to prolong the longevity of the implants, bone blocks or particulate xenografts? I am especially concerned if a fenestration of the buccal plate occurs during the drilling of the osteotomy. What do you recommend?
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