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Bob has second surgery

March 02, 2015

By Kimber Solana

Follow Bob logo

In Robert “Bob” Hartman’s first surgery his upper teeth were extracted, bone grafts were placed and an immediate denture was delivered as his provisional restoration.

In the lower arch his teeth were extracted, alveoloplasty was performed using a bone reduction guide and six implants were placed. A screw retained provisional was fabricated by retrofitting an immediate lower denture.

Next, Bob had to wait four months to heal  before proceeding.

“It’s just human biology,” Bob said. “There’s a lot of healing and waiting.”

In August 2014, Dr. David Little, of San Antonio, placed four implants in Bob’s upper arch.

The procedure was accomplished using guided surgery. A soft tissue-supported Simplant guide was used with the Ankylos Expert Ease guided surgery kit.

Bob's surgery
Second surgery: Dr. David Little (right) and his dental assistant Erica Mesa work on Robert “Bob” Hartman during Bob’s second procedure for his full-mouth reconstruction. The second surgery occurred Aug. 19, 2014, in San Antonio, where Dr. Little placed four implants in Bob’s upper arch using guided

The process was documented as part of an upcoming course in the “Follow Bob” CE online series, which tracks a patient’s full-mouth reconstruction procedure from diagnosis to surgery.

The process, which began April 2014, is expected to take 18 months. It will culminate in a three-hour Education in the Round course at ADA 2015 in Washington, D.C., led by Dr. Joseph Massad, who co-treated Bob with Dr. Little.

Both dentists have used the latest technologies to map the course of Bob’s treatment from surgery to final restorations.

The second procedure was another success as Bob now waits for the implants to osseointegrate, or fuse, into the bone and create an anchor for the final prosthesis.

To view the first online course, visit and search for the session titled “Treatment of a Failing Dentition with Prosthetic Driven Implant Considerations. A 4 Part Series Part 1: Diagnosis and Prognosis of a Failing Dentition.”