Atypical implant situations 641

Fig. 15-36. The completed case, showing the teeth to be in a Class I relationship.

Fig. 15-37. The final Panorex.

crest. The only available bone was distal to the maxillary sinus in the maxillary tuberosity.

After careful evaluation of the radiographs, study casts, and the patient's mouth, the anterior quad-rant of teeth were prepared to drastically reduce the overjet. This involved removing a great deal of the labial surfaces of these teeth, exposing the nerves and removing them, and filling the canals (Fig. 15-40).

The remaining teeth in the maxillary arch and

the four lower posterior teeth on each side of the mandible were prepared. The lower anterior six teeth—being in good condition, free from caries, and with excellent bone support—were left alone.

Copper tube modeling compound impressions were taken of all the prepared teeth, as well as plaster indices and a wax interocclusal record of centric relation. The vertical dimension was not to be in-creased. The castings were placed on the master stone models (Fig. 15-41) .