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CLINICAL Providing Fixed Provisionals on Immediately Placed Implants by Ara Nazarian DDS, DICOI W Figure 1; Preoperative view of lower dentition hen a patient presents to your dental practice with non- restorable teeth requiring full mouth extractions, the biggest concern is whether or not implants can be placed at the same surgical visit and if so will they be able to walk out with fixed teeth. Having an implant within your practice that allows you to load or progressively load, so that these patient’s demands are met, allows you to position your practice to a whole new level. Of course, certain parameters must be met in order to facilitate this type of treatment. This includes, but is not limited to the quality and quantity of bone, the presence of infection, the patient’s health and the skills of the dental provider. Additionally, the selection of the most appropriate materials for the most ideal situation must be met. A patient presented to my practice for a consultation wanting to restore her lower dentition. She complained of generalized discomfort in these teeth due to the gross caries and periodontal disease that was readily apparent (Figure 1). The upper arch was already edentulous and restored with a denture. Planning Figure 2; CS 8100 3D A CBCT scan using the CS 8100 3D (Carestream Dental) (Figure 2) was taken to accurately treatment plan this case to make certain that no complications would arise from doing all the procedures (extract, graft and implant placement) within one visit. Since her entire lower dentition had caries as well as periodontal disease, the treatment would require extracting all the remaining teeth. To further develop a treatment plan, diagnostic models were forwarded to the dental lab and mounted on the articulator for further analysis in order to meet the patient’s esthetic and functional needs. Additionally, a 3D virtual treatment plan was created with the assistance of 3DDX (Figure 3). The patient desired having fixed restorations supported by dental implants in the lower arch that would oppose a new complete denture Figure 3; Virtual Treatment Plan 44 T P D winter 2 0 1 6 The implants utilized in this case were OCO Biomedical’s Engage dental implants. These implants are known for their unchallenged high implant stability at placement which is a critical success factor in these immediate load cases. With the combination of their patented Bull