Ridge-Preservation Open membrane technique with Geistlich Bio-Gide® and Geistlich Bio-Oss®, implant Placement. A case report:
CASE
37years old female
First visit 2016.10
No medical history
2016.12.
45 extraction, and debridement of the inflammatory tissue.
Filling with Geistlich Bio-Oss® (small granules 0.25-1mm)
Buccal bone wall replaced by Geistlich Bio-Gide® (13×25mm) double-layer technique
Geistlich Bio-Gide® is sutured with a modified cross-mattress suture with 4-0 PTFE, allowing optimal adaptation between the borders of the soft tissues and the collagen matrix
Situation after 17days after surgery
Note the epithelium has become stretched
2017.7
Clinical situation after 8 months of healing,
Maintains the alveolar volume
45 implant placement(Nobel active Rp4.3*11.5mm)
primary stability is very good
Final prosthetic and well maintained the alveolar volume
This case presents a fracture of tooth #19 which is the distal abutment for a four unit bridge tooth #19-22, with pontics in the #20 and #21 positions. The patient wanted a implant restoration at positions #19, #20 and #21 and thus, lateral ridge augmentation with autogenous bone and Geistlich Bio-Oss® and Geistlich Bio-Gide® was performed.
Multiple buccal recession defects ranging 2-5 mm were noted by teeth #11-14 with a minimal amount of keratinized tissue on the buccal of #14. Bone levels were within normal limits with no loss of interproximal tissue observed. These recession defects are classified as Miller Class I recession defects. Typically, 100% root coverage is expected for recession defects of this type. The treatment was complete root coverage of the recession defects and augmentation of the width of attached keratinized tissue by tooth #14. Complete root coverage and an increase in the zone of keratinized tissue was obtained and a dento-gingival complex that is amenable to long-term health and stability was achieved. The patient was spared from the inevitable morbidities associated with a sub-epithelial connective tissue graft from a palatal donor site.
A patient with a progressive gum recession which had led to compromised esthetics and sensitivity. The teeth had 3-4 mm of gingival recession on the buccal surface with a sufficient zone of
keratinized gingiva. The patients' main priorities were to improve
esthetics and reduce/eliminate root sensitivity. Treatment goals for this case were to obtain complete root coverage, increase soft-tissue thickness, and reduce/eliminate cervical sensitivity. Using Geistlich Fibro-Gide® a 100% root coverage has been obtained
and the patients' chief complaints of esthetics and sensitivity have been addressed.
The patient has a root fracture at tooth 11 and due to the root micro movement in the alveolar ridge together with the periodontal bacterial infiltration, the buccal bone was resorbed (type 2 class). Tooth 11 was extracted atraumatically and the socket preservation procedure was performed in accordance with the open-healing protocol. The final outcome was stable, from both functional and esthetic points of view, reinforcing the biological advantages using the open-healing technique followed by fl apless tissue level implants in the esthetic zone.
