Abstract
Alveolar ridge deficiency is considered a major limitation for successful implant placement, as well as for the long-term success rate, especially in the anterior maxillary region. Implants placed without regard for prosthetic position often results in dental restorations that are functionally and esthetically compromised. Adequate peri-implant bone support is essential for immediate and long-term implant stability, as well as for future esthetic outcome. To achieve this goal, augmentation of lost bone is often necessary. A variety of surgical approaches have been proposed to enhance the alveolar bone volume. Guided bone regeneration (GBR) is the most common technique for localized bone augmentation. GBR, by application of cell occlusive membranes that mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, has become a well-documented and highly successful procedure for localized augmentation of the atrophic jaw before or simultaneously with implant placement. This case report presents simultaneous approach of guided bone regeneration and implant placement in the maxillary anterior region with narrow ridge defect.
Highlights
Implant therapy in the anterior maxilla is challenging for the clinician because of esthetic demand of the patients and difficult preexisting anatomy.[1]
Patient was advised for Cone Beam Computed Tomography (CBCT), buccolingual width was measured 4.67mm and there was adequate height for implant placement (Figure 3)
Guided Bone Regeneration (GBR) is a technique in which bone growth is enhanced by maintaining the space and preventing soft tissue growth into the area utilizing either a resorbable or non-resorbable barrier membrane and achieving the bone regeneration
Summary
Implant therapy in the anterior maxilla is challenging for the clinician because of esthetic demand of the patients and difficult preexisting anatomy.[1]. Extraoral and intraoral examinations were done (Figure 1, 2) Gingival biotype in this area was thick and there was concavity or crater like defect with deficient buccal bone, Siebert’s class I defect (Figure 2). Patient was advised for Cone Beam Computed Tomography (CBCT), buccolingual width was measured 4.67mm and there was adequate height for implant placement (Figure 3). As implant had to be placed in anterior maxilla, esthetic risk analysis was done. The factors that contributed to medium risk included patient expectation, bone level at adjacent teeth was about 5.5 mm to contact point and horizontal bone deficiency present. Implant was placed considering buccolingual, mesiodistal and apicocoronal position (Figure 5). Stabilization of the membrane and the underlying graft material was achieved by using horizontal mattress sutures extending from the apical portion of the facial periosteum to the palatal aspect of the flap. Oral hygiene instructions were reinforced and recalled for regular follow-ups
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