Occasionally a patient presents himself with only the anterior quadrant of teeth missing and strong posterior teeth remaining, fig. 1. Usually in these situations the teeth were extracted in-stead of restored with root canal therapy and full coverage because of poor dentistry or the patient's inability to pay for a more expensive restoration at that time. The incision and reflection of the soft tissues is accomplished, fig. 2, prior to grooving the bone and preparing the teeth, fig. 3. The midline blade is inserted and tapped to its proper depth, figs. 4, 5, and sutured, fig. 6. After healing, fig. 7, the final partial fixed bridge is cemented with hard cement using a few abutments on each side, fig. 8.

In similar anterior bridgework situations, requiring midline implants immediately after the four or as in this case, three, anterior periodontally involved incisors had to be removed, the results can be the same, figs. 9, 10, 11, 12. A periapical film of the midline blade, fig. 13.

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