This patient had advanced gum disease affecting the lower front teeth. Gum disease is a condition that in this case resulted from the unattended accumulation of plaque, which was made worse by the crowding of the teeth, as seen in the first sequence picture.
After removing the lower 4 front teeth, two dental implants were placed in alternate sockets. It was not possible to place implants on either end of the gap because there was not enough bone for an implant on the one end.
The two fixtures were fitted with healing abutments and were left to heal. After 3 months of healing, a 4-unit porcelain bridge supported by the two fixtures.