This case shows the placement of four implants immediately after extractions, and the final rehabilitation with a denture over an Ackermann bar.
Several years’ edentulism has left ridge bone collapsed.
The only places where the implants can be set are exactly where the four remaining teeth are.
But it even in these places the cortical layers are very thin and concave. There are even bone defects after the extractions, too.
On the left side, I fill the gaps between corticals and implants with Bio-Oss bone graft and cover it with a Bio-guide resorbable collagen membrane fixed by the healing screws.
On the patient’s right side, more of the same. Thin, almost transparent, concave corticals, leaving groove defects after extractions. Same procedure, as before. Graft and membrane.
Two week’s healing, prior to removal of stitches, and Ackermann bar screwed over the implants.
Clamps under the denture hold onto the bar.