CLINICAL CASE

1 – Pre-operative radiograph showing the severe bone defect around the tooth.
2 – Six weeks after tooth extraction, uneventful soft-tissue healing in the post-operative phase is visible.
3 – After flap preparation, an implant was placed in a site with a severe bone defect.
4 – In order to fill up the defect and provide volume stability Geistlich Bio-Oss Collagen® was applied.
5 – After augmentation with Geistlich Bio-Oss Collagen®, the site was covered with a collagen fleece.
6 – Final crown restoration after 6 months post-operative.
7 – The radiograph after 25 years shows a stable bone situation.
8 – The clinical picture after 25 years follow-up presents a very nice and stable bone and soft-tissue situation.

CLINICAL CHALLENGE:

The upper premolar had to be removed due to advanced periodontal disease and severe bone loss around the infected tooth. The bone defect was an intra-alveolar defect without dehiscence or fenestration.

AIM/APPROACH:

An early implant placement approach with a healing time of six weeks before implant placement was chosen. The bone augmentation with Geistlich Bio-Oss Collagen® was conducted simultaneously with implant placement. As this patient was treated in 1991, the case is one of the very first clinical applications of Geistlich Bio-Oss Collagen®

CONCLUSION:

A premolar grafted with Geistlich Bio-Oss Collagen® during implant placement showed good long-term result after 25 years. Satisfactory hard and soft-tissue contour are present 25 years after implantation.