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Bone Graft
Patient came in with a very large buccal alveolar bony fenestration due to the abscess that was present in the past. Upon raising a flap, the defect could be seen very well visually, and its size was more than 4~5mm in diameter. The surgical site was grafted with Allograft bone with Collagen membrane to aid in proper bone healing, followed by dental implant placement.
The case well demonstrates the effect of long-standing chronic abscess from an untreated, failed endodontic (root canal) treatment which we can often see in lots of patients—severe apical and facial resorption or the surrounding alveolar bone.
The graft used was Allograft mixed with Xenograft, followed by closure with Collagen membrane and sutures. Uncovered bone was very nice to receive a dental implant and its final crown.
Patient‘s very loose lower central incisors had Class 2-3 mobility with severe vertical & horizontal bone loss with attachment loss nearly down to their apices. First phase was to perform a GBR (Guided Bone Regeneration) to increase the amount/volume of the bone. Then, two narrow-ridge dental implants were placed into the healed bone, which lead to successful implant restorations.
Lower right 2nd premolar and 1st molar were extracted and grafted due to an advanced periodontal defects involving both hard and soft tissues around them. During extraction procedures, it is vital to remove all granulation tissues as well as all remnants of bacterial infection inside the teeth's sockets. Patient will need two implants once the graft heals completely.
Patient had chronic severe periodontitis on upper left and lower left molars. Class 3 mobility, severe horizontal & vertical bone resorption and perforation of maxillary sinus floor were observed. The perforated floor was managed with barrier membranes and all extraction sites were grafted followed by primary closures.
Patient presented with a tooth fracture, which was found to be both vertical and horizontal complete tooth fractures. The tooth was previously treated with root canal, however, the lack of a full-coverage crown had lead to the trauma. The tooth was extracted followed by graft to prepare for a future implant placement.
Hopeless upper right 2nd molar was removed and abscess was cleaned out prior to bone graft for periapical and palatal surfaces of the socket. Sinus floor was visible without a perforation. Non-resorbable PTFE membrane was used for complete sealing of the graft material. The patient returned after 4-weeks for the membrane removal, and a follow-up.
Lower Central Incisors were left untreated for a few years after having small cavities. Large caries and fractures with Class 1-2 mobility at the time of the exam. After patient’s consent, extractions and bone graft were performed.
Upper left central incisor had severe vertical bony defect with abscess on its Disto-Facial surface. The tooth was evaluated with CBCT scan prior to extraction, immediate implant placement and bone graft. Healing abutment was placed 2 months after the surgery, and final crown was restored after osseointegration of the implant In about 6 months.
1st Molar was periodontally compromised with bone loss, attachment loss and mobility as well as endodontically had failing root canal treatment. Extraction and bone graft was performed to prepare for the following implant surgery.
Failing implant with Facial, Mesial, Distal bone loss was observed on the CBCT scan after patient presented with interproximal gum loss, recurring smell in the mouth and gum swelling/discomfort on the upper lateral incisor.
The old implant fixture was removed and grafted with GBR technique using a Titanium screw to gain more bone volume and height. Primary closure with collagen membrane and suture.
Patient’s existing 3-unit bridge restorations were mobile, painful to chewing due to mobility. The abutment tooth (2nd molar) had periodontal disease which required extraction. The bridge was removed with the 2nd molar, and the extraction site was grafted with Allograft and non-resorbable membrane. At the same time, implant was placed on the 1st molar region. As the final restorations, the patient received one regular crown & two implant-supported crowns.