Angulated implants: How would you restore this case?

Last Updated June 24, 2019
Reviewed By:  Dr. Dale Gerke

My patient is an 84 year old female. She has no medical issues other than slight anemia. Last Hgb 9.9. We removed all her lower teeth and grafted except for #31. Keeping #31 to help anchor rpd for now then will extract after implants have been restored. She has existing implants at #19, #20. She is currently wearing a removable partial denture. She wants fixed non removable teeth. I have treatment planned to place 4 implants between the foramina and then restore with a 12 unit fixed bridge from 19-30. My concern is the angulation of the most anterior implants. The bone anatomy is such that the implants would be angulated slightly towards the buccal. This is evident in the pre-op photos and post grafting CT scan. Can I restore the implants with a fixed bridge with this type of angulation? Also, is it better to do a screw retained vs cement retained 12 unit bridge for this particular case? What would you do? Thanks

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