This case presents severe periodontal disease. The only logical treatment plan is full extractions and new denture.
The bone ridge is very damaged and there too many irregularities as to approach immediate implants after extractions. I prefer having the teeth extracted and wait until the bone ridge is in better, safer shape.
In addition, an impacted upper right cuspid will leave a big hole in the bone in an area that I will need to use for implantation.
So, I proceed to extract the cuspid and fill the bone defect with Bio-Oss graft, covering it with a resorbable Bio-Guide membrane.
Then, all the teeth are extracted by his general dentist, who places a removable denture while waiting for the bone to heal.
Then, I place six implants on each jaw.
Note the unexpected, deep bone defect that laid after previous extractions of the upper right molars, which was filled up with soft tissue.
I use Bio-Oss bone graft and Bio-Guide resorbable membrane to cover the cavity and place the last implant on the front side of the defect.
This is the final result after 6 months, ready for his general dentist to initiate the fixed prosthesis.