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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