Jeremy Bewley .....to place an implant and graft simultaneously and achieve an acceptable outcome in this case?
Let me give you some background: the patient is a 74 yo male, medical history includes type 2 diabetes and hypertension, for which he takes meds and both conditions are controlled. He had #19 extracted at another office approximately 8 months prior to the CBCT images you see above. He has adequate thick attached tissue and restorative space. He has had a couple of other opinions provided already.
His ask is this: he wants an implant placed and any defects grafted in one procedure. He is aware that he will have to return at some point later on for the crown, he just does not want to have multiple surgeries if at all possible. He desires this because he's not getting any younger and doesn't want to spend any more time than he has to away from his job and his vacation house.
What do you think? Tell him he has no choice but to perform a ridge augmentation first? Go for it with the understanding that there may be complications that require more surgeries to correct?
