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Case study

Ridge Preservation in the anterior maxilla

06.09.2015
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A case series investigation of whether it is possible to insert an implant just four months after a Ridge Preservation.

Dr. Beat Wallkamm | Switzerland

A 75-year-old female patient was referred for the extraction of teeth 21 and 22. An implant restoration in region 21 (screw-retained) with an extension bridge was planned. Both teeth had gingival recessions, although the patient had a thick biotype. The patient had a deep smile line.

After the careful removal of tooth 21, the extraction socket was filled loosely up to the crestal edge of  the socket walls with Geistlich Bio-Oss® Collagen. A disc of collagen matrix, Geistlich Mucograft® Seal, was adapted to the deepithelialized wound margins over the bone replacement material and stabilized with a mattress suture. Tooth 22 was initially left in situ and served as an anchoring point for the temporary crown x22.

The healing progressed smoothly. After three weeks, the epithelization over the collagen matrix was complete. After four months, the implant (Straumann Bone Level NC Implant Roxolid SLActive) was inserted in the correct prosthetic position. The newly formed bone had matured by this time, and there was sufficient primary stability.

After a further two-month healing phase, the reopening took place, and a conical healing cap was inserted. The patient was referred back to the dentist treating her for the prosthetic restoration and the extraction of tooth 22.Two years later, the probe values around the implant were 3 mm. The extension of the crown (tooth 22) had no contact in the articulation. The patient was very happy with her treatment.


What should be taken into consideration?

The case is part of a case series, in which the effectiveness of Ridge Preservation in combination with a late implantation was tested. One of the objectives of the case series was to evaluate the earliest possible time for implantation after Ridge Preservation. For this reason, the implant was inserted

after just four months, although this is a relatively early implantation time after bone regeneration with bovine bone replacement material.

A biopsy was taken in order to assess the condition of the bone after four months. The degree of maturity of the new bone was sufficient for a primary stable implant insertion.

 

Aftercare planning

Cooperation with the referring dentist is of great importance for a successful treatment. The patient’s oral hygiene barely fulfilled the requirements for implant placement. We recommended that the dentist arranges more frequent recall appointments for professional tooth cleaning.

Dr. Beat Wallkamm

Dr. Beat Wallkamm | Switzerland

Praxis Wallkamm
Langenthal

Illustration Header: Alessandro Holler / Quaint

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