The patient is a 55 year old white woman. She presents with a failing maxillary removable partial denture and a chief concern for the esthetic component of the completed restoration. Her medical history is non-contributory and her dental history includes an early trauma to the pre-maxillary area resulting in the loss of teeth and suppporting tissues. The maxillary arch is edentulous except for the left cuspid and left first molar. The mandibular arch has a porcelain-fused-to-metal reconstruction of poor quality.

The maxillary cuspid is severely periodontally involved and hopeless. The first molar is a sound tooth with excellent periodontal support. The poor occlusal plane on the lower restoration is a major cause for concern, but treatment of the lower arch is beyond the patients present parameters. Treatment was designed to construct an implant supported maxillary partial-overdenture utilizing the maxillary molar and several anterior implants.