Treatment planning for implant placement with narrow mesiodistal space?

Last Updated May 27, 2014

I would like to ask a question about one of my upcoming implant cases which happens in about 10 days time.

I have a 53 year old healthy female patient with a low smile line and the patient has low aesthetic expectation of the treatment.

The problem is that the mesiodistal space is quite narrow. The mesiodistal distance is 12mm between the adjacent cervicals of #10 and 13 and 9mm between the coronal proximal contact points. Radiographically the mesiodistal distance is 14.6mm. Using the standard analysis, I am planning: 2mm (from tooth to the implants) +3.25mm (NP implant) +3mm (between implants) + 3,25 mm (NP implant) + 2mm (from implant to the tooth) = 14.50mm

I am planning to place Biomet 3i Tapered T3 NP 3.25mm x 11.5 or 13mm X 2. Since there is no room for an error, I have prepared a surgical stent. In addition, I am planning to modify the mesial part of the PFM crown on tooth #13 to make create more space.

What are your thoughts on this case? What, if anything, would you do differently ?

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