A 60 year old patient came with severe pain in some lower teeth and problem of difficulty in eating .After through examination all lower teeth had poor prognosis and advised for extraction and out of all options ,all on four immediate implants was planned .Patient wanted lowers to be done before uppers . Anteriorly Bone ostectomy was done to get wider bone width and posteriorly also ostectomy was done to get a equal ramp for easy prosthesis fabrication .
Osstem 4*11.5 Implants were placed anteriorly and 4.5 X 11.5 mm were placed posteriorly .
