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Treatment Solutions
- 2-Stage Implant Placement(30)
- Gain of Keratinized Tissue(14)
- GBR Procedure(36)
- Peri-Implantitis Therapy(7)
- Recession Coverage(19)
- Ridge Preservation(32)
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Found 36 Results

Waldemar D. Polido, DDS, MMS, PhD
Wel-Shao Lin, DDS, FACP, PhD, MBA

Bone Grafting and Immediate Implant Placement in the Maxillary First Molar Region

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Pre-operative occlusal view showing the involved tooth’s condition.

Pre-operative periapical radiograph capturing the cross-section of the involved tooth.

Comprehensive Digital Planning for Implant Placement – A multi-view CBCT and 3D reconstruction showcasing precise anatomical assessment and guided surgical approach.

Geistlich Bio-Oss Collagen® placement, demonstrating the material packed around the implant within the socket.

Immediate provisional crown, occlusal view showcasing restoration alignment technique.

Immediate crown periapical view, reflecting the initial stability of the implant and prosthesis.

Final crown occlusal view, illustrating the restoration’s integration and final crown periapical view, emphasizing implant stability post-restoration.

Occlusal view at the 3-year post-implant placement, highlighting tissue health and crown durability. Periapical CBCT view at the 3-year post-implant placement, providing insight into bone stability over time.

1 - Baseline frontal view: missing central incisor.

2 - Baseline occlusal view: The facial contour is flattened by physiological dimensional ridge alterations post-extraction.

3 - Full-thickness flap using one releasing incision in the distal aspect of the canine. Simultaneous contour augmentation using GBR was performed with autogenous bone chips to cover the exposed implant combined with a layer of Geistlich Bio-Oss®and Geistlich Bio-Gide®.

4 - Application of Geistlich Fibro-Gide® on top of the augmented area. A tension-free primary wound closure was obtained by a periosteal releasing incision.

5 - Suture removal 14 days post-surgery. Uneventful wound healing and an increase in soft-tissue volume.

6 - Frontal view 4 weeks post-surgery.

7 - 2 months follow-up combined with abutment connection.

8 - Occlusal view of final restoration 2 years post-surgery.

9 - Final restoration 2 years post-surgery shows pleasing esthetics.

Pre-operative situation showing the horizontal ridge deficiency (left). Buccal bone concavity evident after full thickness flap elevation (middle). There is insufficient bone to place implants in an ideal restorative position (right).

It is important to locate the mental foramen. Intramarrow penetrations were done to allow for improved blood supply to the bone graft.

The clinical cocktail used for guided bone regeneration: 1) 50/50 mixture of autogenous bone chips, collected with Geistlich SafeScraper TWIST, and Geistlich Bio-Oss®, and 2) Geistlich Bio-Gide® Compressed 20 x 30 mm and 13 x 25 mm.

“Sticky bone”, created by combining PRF with the bone graft, adapted well to the site of the defect. Periosteal biting sutures were used for stabilization of the multiple layers of Geistlich Bio-Gide® Compressed and underlying bone graft.

Geistlich Bio-Gide® Compressed was carefully trimmed to be mindful of the mental nerve.

Tension-free primary closure achieved with horizontal mattress sutures and simple interrupted sutures.

Re-entry and CBCT scan at 8 months showing a significant increase in horizonal bone dimension.

Sufficient regenerated bone to allow for implant therapy (left). Implants #19 and #20 placed. Vital bone from guided bone regeneration as evidenced by the bleeding bone (middle). Tension-free primary closure achieved using 5-0 glycolon sutures.

Implant placement planned for site #3 and #5 with soft-tissue treatment utilizing a CTG and for sites #10, #12 and #13 with soft-tissue augmentation using Geistlich Fibro-Gide®

2 - Uncovering of site #10 shows a narrow ridge width and an insufficient amount of soft-tissue thickness.

3 - Tooth #10 was extracted and immediately replaced by an implant.

4 - Fill the gap procedure with Geistlich Bio-Oss Collagen® to achieve contour augmentation and preserve horizontal ridge dimensions.

5 - Geistlich Fibro-Gide® was trimmed to half of the thickness to fit the defect and placed into sites #10, 11, 12 and 13.

6 - The entire site was closed tension-free to facilitate uneventful wound healing.

7 - The 3 month follow-up shows uneventful soft-tissue healing and an increase of soft-tissue thickness at the desired sites.

8 - The 6 month follow-up with the final reconstruction shows that the soft-tissue thickness at the desired site is maintained over time. This contributes to an esthetic and pleasing outcome. (Restorative work by Dr. Chao-Chieh Yang, IUSD)

9 - The 2 month follow-up showing a comparison of the treated sites, one with CTG (left) and one with Geistlich Fibro-Gide® (right) in the same patient. Comparable results have been achieved with both treatments, but without the need for a donor site.

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