Localized ridge augmentation with simultaneous implant placement followed by soft tissue augmentation in the maxillary anterior region: A case report

Abstract

A deficient alveolar ridge in the maxillary anterior site often warrants ridge augmentation prior to prosthetic rehabilitation, in order to enhance functional and esthetic outcomes. In particular, if implant therapy is planned in a deficient jaw, ridge augmentation is preferred before or simultaneous to implant placement in order to overcome the anatomic limitations of the residual jaw bone crest. Guided bone regeneration (GBR) is the gold standard technique for bone regeneration in patients with atrophic ridges, and it is regarded as one of the most predictable techniques for ridge augmentation. Non‑resorbable membranes, such as titanium mesh are preferred in the GBR procedure, due to the enhanced rigidity and microporous structure, facilitating vascularity. However, the most common disadvantage of non‑resorbable membranes, when used in vertical augmentation, is the soft tissue dehiscence. However, tissue stability is essential for the long‑term successful outcomes of GBR. The present study focuses on the evaluation of the clinical and radiographic outcomes of a patient undergoing GBR using customized titanium mesh and xenograft simultaneous to implant placement in the maxillary anterior region. In addition to the hard tissue augmentation, soft tissue augmentation was performed using injectable platelet‑rich fibrin and a collagen membrane. Following 6 months of GBR, the augmentation site exhibited clinically and radiographically significant gain in ridge dimensions, with an average bone gain of 2.8 and 3.1 mm in horizontal and vertical dimensions, respectively with stable soft tissue support.