CLINICAL CASE

1 – Pre-operative photograph showing the horizontal bone defect at sites #18 and #19

2 – Cone-Beam Computed Tomography (CBCT) showing the horizontal and vertical bone defects at sites #18 and #19

3 – Full-thickness flap reflection and buccal flap release to achieve tension-free primary closure

4 – Harvested autograft and vallos™ fibers hydrated with platelet-rich plasma and placed in the Yxoss CBR®mesh

5 – The titanium mesh was covered with a Geistlich Bio-Gide® Compressed membrane and platelet-rich fibrin (PRF) membranes

6 – week post-operative healing of surgical site shows increase in tissue width and no membrane exposure

CLINICAL SITUATION:

A 60-year-old female presented to the periodontics clinic at UTHSA for implant placement at sites #18 and #19. Upon clinical and radiographic examinations, the lower left edentulous ridge was diagnosed as a Siebert class III due to the presence of bucco-lingual and apico-coronal tissue defects. The treatment proposed included soft tissue grafting for increase of keratinized tissue followed by ridge augmentation using Yxoss CBR^®mesh and a mix of autograft, vallos^™ fibers, and platelet-rich plasma (PRP)

OUTCOME:

The vallos^™ fibers combined with autogenous bone and the PRP created a stable fibrin bone graft that could be easily molded and contained within the mesh. Hydration with PRP was progressive until the graft reached the desired consistency. Wound healing following ridge augmentation was uneventful. There were no signs of infection or membrane exposure at the site. Mesh removal and implant placement is planned at 6-months following ridge augmentation.