Overview
Challenge: Is this patient a candidate for an FP1 or FP3 prosthesis? What factors influence the decision, and how should treatment be planned to achieve the desired outcome?
Treatment:
A staged approach was selected with the goal of achieving an FP1 restoration. Immediate implant placement was avoided due to the patient's poor oral hygiene, long-term smoking history, and the need for site development before implant placement.
FP3 option would have required unnecessary bone reduction. By utilizing a staged FP1 approach, the patient's natural hard and soft tissue architecture can be preserved, resulting in a more favorable esthetic outcome.
Treatment Planning
Treatment included selective extractions, GBR, and fixed provisional restorations as transitional prostheses. A full virtual wax-up was completed first to establish the ideal tooth position, evaluate esthetic requirements, and guide implant planning. The final prosthetic design was determined before any surgical treatment was initiated.
Clinical Steps
Pre-operative Image & Pano
Virtual wax-up and prosthetic planning
Exocad was used for virtual Wax-up and smile Design, Fixed provisional
Fixed provisionalization Design
Implant position planning
Blueskybio software was used for virtual implant planning.
A staged approach allowed for improved site development and prosthetically driven implant positioning. This created a more predictable foundation for the final restoration while minimizing surgical and restorative compromises.
Printed Fixed Provisional Template
Surgical Procedure
Sticky bone and PRF membranes were used for GBR procedure.
Clinical Pearls
✓ Start with a full virtual wax-up before implant planning using either Exocad or Blueskybio software
✓ Implant position should be driven by the planned prosthesis.
✓ The decision between FP1 and FP3 is largely determined by esthetics, tissue loss, and smile line.
✓ In high-risk patients, a staged approach may improve long term predictability.
Detailed treatment planning, prosthetic considerations, and surgical workflow for this case will be shared in the ECDA Case Review.
Detailed step-by-step protocols for GBR, phlebotomy, sticky bone preparation, and PRF membrane fabrication are covered in ECDA Module A.
