Retained root #11,13. Patient reports that a previous dentist attempted root canal therapy and crowns but they fractured shortly after delivery.
Ext + immediate implant #11,13
Cantilever FPD #10-11
Thoughts... I feel comfortable with an FPD #6-8. I'd prefer #9 to be a single crown as opposed to being part of the FPD. Mainly for hygienic reasons, but also for future retrievability. I'm still not completely comfortable doing a tooth-implant FPD, so to restore #10, I planned on doing a mesial cantilever from the implant crown #11. And for #13 a simple implant crown. After examining the radiographs, and noticing small and tapered roots, I planned for extraction with immediate implants. For this case, i'll use Nobel Speedy Groovy RP x 11.5mm. The implant abutments are custom zirconia abutments made using the Nobel Procera system. All restorations are zirconia with layered feldspathic porcelain. I designed my occlusion so that in centric there is even contact on all teeth, except light contact on the pontics #7 and 10. I use shimstock to make sure it holds firmly on all teeth, but glides on #7 and 10. In protrusive I want contact on #6,8,9,12 and immediate disclusion of posterior teeth, the pontics, and the implant crown #11. On right excursive I have group function #5/6. On left excursive, group function #12/13.