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An interesting case of teeth extraction, implants placement and bone augmention with ridge reconstruction. A 61 years old patient came to our clinic complaining from severe periodontal disease and mobility of upper teeth, which were covered by a long span bridge of 11 units. The bridge was done on five natural teeth. The teeth and the bridge were mobile and with a severe gum recession and inflammation. The panoramic x-ray showed peri-apical lesions and chronic periodontal diseases with bone resorption around all five teeth. These teeth were indicated for extraction. Also the panoramic x-ray showed the drop of maxillary sinus and the indication for sinus lifting on teeth 15, 16 and 26, 27. The patient had a bad oral hygiene, and after we controlled his oral hygiene we decided to remove the bridge and also the teeth and replace them by dental implants.