The rehabilitation of a partially dentate patient with a skeletal and dentate Class III relationship remains a challenge. The concerns raised by this patient were aesthetics and loss of function. He had a history of chronic sinusitis and was smoking at least ten cigarettes per day. The intra oral examination revealed loss of posterior teeth due to caries, which resulted in severe bone loss, loss of occlusal vertical dimension and compromising the anterior aesthetics.
Main areas of discussion:
Medical history and the possible consequences of smoking to bone augmentation success and implant survival.
Prosthetic considerations regarding the type of attachment, type of occlusion, the value of wax-ups as well as the differences between internal and external hex connections for implant bridges.
Surgical considerations regarding the type of bone augmentation procedure and the timing of implant placement.