Mr PH is 71 years old. He is a non-smoker with no relevant medical history. He had only a root of LL7 in the lower jaw, his other lower teeth having been lost many years before. He had never worn his bottom denture. He admitted that since his wife died three years before he had ‘let himself go’ but now was determined to start again. His first move was to buy himself a BMW Z3 and now he wanted to improve his appearance.

Initial examination consisted of a clinical evaluation, an OPG and a lower occlusal X-ray. These confirmed that he would be suitable for a Novum system restoration. He had researched implant treatment himself and was well aware of the procedure and the cost. He agreed to go ahead with the treatment and declined sedation for the surgical stage.

Prior to treatment day, models were articulated and the lower model trimmed as accurately as possible to mimic the necessary ridge reduction to be performed. A stent was made to allow the surgeon to reduce the ridge accurately, keeping it level and ensuring that the vertical dimension could be maintained. A bite block was also made on the upper bar. Restoration of the upper jaw was completed before the initial bite recording was made It was decided to extract LL7 root when the rest of the surgery was done.

On the day of treatment the surgery was started at about 9.30am. By 11.15 the surgical stage of placing the implants and connecting the lower bar was completed. The patient had a short rest and then the bite and facebow reading were taken. The technician took them away to set the teeth up for a try-in of the prosthesis while the patient had a light lunch and read the paper.

At the try-in stage a check bite was taken and the appearance was approved by the patient. The final restoration was fitted at 5.30pm.

A week later the sutures were removed, the bite checked again and oral hygiene procedures explained. Mr PH’s only regret about the whole treatment was that it had not been invented earlier.

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