Bone augmentation and simultaneous implant placement with autogenous bone – Case report

Abstract

Background Dental implant implantation has become a routine procedure today. When bone support is inadequate for implant application, bone tissue is tried to be formed by various methods. Alveolar bone augmentation techniques include different surgical approaches such as guided bone regeneration, onlay grafting, interpositional grafting, distraction osteogenesis, ridge splitting, and socket preservation. Implant restoration needs to be surrounded by hard and soft tissue environment that is in harmony with the surrounding dentition. implant restoration needs to be surrounded by hard and soft tissue environment that is in harmony with the surrounding dentition. Aim/Hypothesis This case describes a surgical technique of applied maxillary incisor implant and autogenous bone graft in the form of ìbone ringî harvested from the symphysis. In this case, both vertical and horizontal direction bone gain was desired. Material and Methods A 62-year-old man presented with mobile lateral incisors after definite periodontal treatment. The panoramic radiograph showed moderate to severe bone loss around the tooth. The patient underwent extensive full mouth periodontal therapy including scaling, root planing, and oral hygiene instructions to control his periodontal problem. Extraction decision was taken because there was no decrease in mobility after periodontal treatment. When patients come to our clinic after 3 months we have seen it is not enough bone in the vertical as well as horizontal. We decided to use autogenous block ring grafts thinking about the healing potential. The symphysis was accessed through a genioplasty incision. The mental nerves were exposed and protected. Using an 8-mm trephine bur and drilled through the exposed symphysis. Bone rings outlined in the symphysis with the central osteotomies corresponding to the diameter for implants to be placed. Bone rings after removal from the symphysis. The bone ring were then used to guide the pilot drill over the socket and assist in their optimum prosthetic planned positions. The harvested bone rings were then fitted in the bone. Minor contour adjustments were necessary to ensure their adaptation and stability. Implants were then tapped through the ìbone rings,î achieving and even increasing the primary stability of ìbone ringî and implant to the alveolar bone. Periosteal scoring was then accomplished at the base of the flap to advance and expand the soft tissues and provide primary closure without tension. Results Implants was osseointegrated. We waited 6 months for bone healing and healing was well. Healing heads fitted for prosthesis. There are several advantages proposed by this technique, including a 3-D augmentation of the native alveolar ridge and the ability to provide additional stability of the implant at the crestal region of the implant. Conclusion and Clinical Implications In conclusion, the proposed technique offers multiple advantage of 3-D bone augmentation. Proper treatment planning and careful surgical execution are essential to ensure predictability.