Augmentation and implant treatment
Fig. 1: Pre-operative panoramic X-ray: poor periodontal and prosthetic conditions.
Fig. 2a: Pre-operative CBCT: aspect of the extremely horizontally resorbed alveolar ridges of the anterior part of the mandible.
Fig. 2b: Pre-operative CBCT: aspect of the extremely horizontally resorbed alveolar ridges of the anterior part of the mandible.
Fig. 3: Pre-operative clinical aspect of the anterior alveolar ridge.
Fig. 4: After elevation of the mucoperiostal flap, the sharp-edged alveolar ridge becomes visible.
Fig. 5: Preparation of the osseous graft with the microsaw.
Fig. 6: Detachment of the graft with a chisel.
Fig. 7: Aspect of the bone harvest.
Fig. 8: The graft was fixed with four miniscrews.
Fig. 9: The osseous graft was covered with a PRGF membrane and a barrier membrane for GBR.
Fig. 10: Sufficient horizontal ridge dimensions after a healing period of four months.
Fig. 11: The CBCT shortly before re-entry demonstrated a significant gain of bone volume after augmentation.
Fig. 12: After flap elevation, a good osseointegration and stabilisation of the autograft was noticed.
Fig. 13: After the fixation screws were removed, the four implants with a diameter of 3.75 mm and a length of 11.5 mm were inserted epicrestally without a surgical guide.
Fig. 14: After three months of submerged healing, a successful implant osseointegration without bone resorption was visible on the panoramic X-ray.
Fig. 15: Soft-tissue condition of the anterior alveolar crest at the time of implant-uncovering: lack of keratinised gingiva.
Fig. 16: After uncovering the implants, an Edlan-Mejchar plastic surgery was performed to deepen the vestibulum.
Fig. 17: Aspect after plastic surgery.
Fig. 18: Facial view of the bar construction and PS TiBA abutments.
Fig. 19: Oral view of the bar.
Fig. 20: After an additional healing period of one month after muco-gingival surgery, the bar was inserted.
Fig. 21: Final prosthetic restauration of the upper and lower jaw.
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