There was a patient who came to us for full mouth implants. She wanted to extract all her teeth and replace all of them with implants. After thorough clinical and radiological evaluation, we found that the upper teeth were quite good and periodontally stable, so we did not extract them.

Definitely, they had wear and tear and some decay, so we had to perform certain procedures like root canal treatment in one of the teeth and two restorative procedures in two other teeth. Due to wear and tear, we did veneers for the anterior teeth and crowns for the posterior teeth. We tried to save all the upper teeth and did not extract them.

For the lower arch, except for two teeth, all the teeth were periodontally compromised. However, we could not keep those two teeth either, so we extracted them as well, along with the rest and immediately replaced them with implants. We performed extraction of all lower teeth followed by immediate implant placement.

We did guided surgery for precision of placement. The bone quality in this patient was not very good, so we followed an under-drilling protocol to achieve good initial stability.

In one area, the implant was slightly tilted due to the extraction socket. In another area, a minor deviation of less than 2 degrees was seen in the implant placement. This is sometimes acceptable with guided surgery.

At present, the patient has been given a temporary fixed prosthesis (PMMA with bar). The patient has been recalled after six months for the final prosthesis.