Horizontal ridge augmentation in the esthetic zone

The Situation

An adult female patient presented with a long history of edentulism at site #9. Patient was interested in replacing her missing tooth with a dental implant, and was wearing a Nesbit appliance. The irritation from the ill-fitting Nesbit appliance resulted in irregular and friable soft-tissue at site #9.

Pre-operative CBCT demonstrated a hard-tissue concavity apical to the crest of the bone. The primary goal of therapy was to regain horizontal dimension of hard and soft-tissue to achieve prosthetically-driven placement of a dental implant to replace the patient‘s left central incisor

The Approach

The treatment goal was to regain the horizontal dimension of hard and soft-tissue through guided bone regeneration. In coordination with the restoring dentist, a diagnostic wax up was completed to determine the ideal tooth position and to regain mutually protected occlusion on the patient’s left side. The combination of Geistlich Bio-Oss® and autologous bone chips was used along with Geistlich Bio-Gide® to regenerate the horizontal dimension for prosthetically-driven implant placement.

The Outcome

Adequate hard and soft-tissue architecture was restored with the use of Geistlich Bio-Oss® and Geistlich Bio-Gide® for predictable, prosthetically-driven implant placement. The combination of Geistlich Bio-Oss® and autologous bone
chips provides the best chance for regeneration while maintaining the hard and soft-tissue contours.

Keys to Success

• Identifying and understanding the esthetic
• needs of the patient.
• Prosthetically-driven surgical therapy based on ideal tooth position.
• Incision and flap design to provide adequate blood supply to the graft.
• Adequate release of the mucogingival flap for primary closure.
• Harvesting of autologous bone chips using the Geistlich SafeScraper Twist.
• Stabilization Geistlich Bio-Gide® using fixation pins and sutures.