CLINICAL CASE

1 – Preoperative radiograph depicting the severe bony atrophy in the posterior mandible.
2 – Fixation of the pre-formed osteosynthesis plate with miniscrews.
3 – Augmentation with autologous bone harvested from the angular region of the mandible and mixed with Geistlich Bio-Oss®.
4 – The grafted site including the osteosynthesis plate is covered with Geistlich Bio-Gide® and the tensile collagen membrane is pinned down. Thus, the augmented site is accurately covered and stabilized.
5 – In order to obtain primary wound closure, a double-layered suturing technique is used by combining a horizontal internal mattress and a coronal single stitch technique.
6 – Implants are inserted 6 months after augmentation and the healing abutments are connected to the implants.
7 – Lateral view of the final prosthetic restoration 6 months after implant placement.
8 – Intraoral radiograph 15 months after augmentation procedure showing a stable bony situation.

CLINICAL CHALLENGE:

  • Severely atrophied alveolar ridge with insufficient bone volume for implant placement
  • ­­­­High complication rates and patient discomfort associated with large augmentations when using autologous bone grafts

AIM/APPROACH:

  • 3-dimensional augmentation of alveolar ridge by the fence technique for implant placement
  • At the same time reducing complication rates and patient discomfort