The severely atrophic maxilla can present with some challenges during treatment planning with communication between those performing the surgical and prosthetic aspects of the treatment as well as communication with the patient as to what is being suggested for treatment. This lecture will review the decision making process to simplify the communication and understanding of treating the severely atrophic maxilla and based on the Bedrossian classification gives a guideline for the surgical approach to be adapted based on the patient residual anatomy. This lecture will give an idea to avoid cantilever in the posterior maxilla, increasing the A-P spread, which is very essential for long term implant success. Immediate loading single Drill implant concept ll cut short the No of patient visits as well as can provide final prosthesis in 2 Visits

Dental implants are an ideal treatment plan for the loss of teeth. The science of Implantology is highly dynamic. Dental implants have evolved over the years with the introduction of newer techniques and implant designs such as basal implants, root analogue implants and the socket shield. However, there still exists a dilemma among clinicians regarding the concept of immediate implantation and immediate loading of the prostheses. Rehabilitation of patients with a completely resorbed edentulous maxilla and/or mandible with implants becomes difficult because of inadequate bone quantity, poor bone quality, proximity to the maxillary sinus in the posterior maxilla, mental foramen and mandibular canal. Sinus lift and bone augmentation procedures are required to treat such patients, prior to implant placement. There have been various alternative methods like zygomatic implants and pterygoid implants which have demonstrated higher success rates in compromised bone situations. But these procedures carry a higher risk of intra and post- operative complications. An innovative TTPHIL – ALL TILTTM concept is introduced by Venkatratna nag. The aim of this article is to provide an overview of this technique called Tall and Tilted Pin Hole Immediately loaded Implants

Immediate replacement of teeth designated for extraction is an appealing treatment rationale for both the patient and the operator. While implant insertion at the time of tooth extraction is desirable for a number of reasons, extraction socket morphology, soft tissue biotype, presence of infection, health of the bone and soft tissue, and other factors help determine if the site is ideal for immediate implant placement or not However, it has been associated with a greater risk of facial recession and compromised soft-tissue esthetics. Partial extraction therapy (PET) or synonymously socket shield technique (SST) or root membrane technique (RMT) has been proposed to conserve the facial alveolar contour and soft-tissue esthetics. Partial extraction was performed allowing the socket with the facial root membrane in situ to partially heal for 8 weeks before implant placement. Successful integration and restoration were achieved with very minimal hard- and soft-tissue changes, accentuating satisfactory esthetic results as dictated by objective esthetic assessment. PET with early implant placement may be considered a viable treatment option for selected cases.