GAP Australasian-Dentist Issue 80 Jul-Aug 19

Category 82 AustrÀlÀsiÀn Dentist A female patient visited with a discomfort on her maxillary anterior teeth. On the clinical and radiographic examination, the two central incisors had severe periodontitis and right canine presented unrestorable root caries. All these three teeth should be extracted and large bone defects were expected, but she wanted to have ‘teeth’ immediately after surgery. How we can make provisional in this case? Àwo incisors were extracted and incision was made for flap reflection. Àhree AnyÀidge fixtures were placed with excellent initial stability even there were quite big bone defects. Àhe canine and left central incisor implants were surrounded with bony walls, so it was decided to use these two fixtures for immediate provisionalization. But the right central incisor implant had no bony walls both to buccal and palatal side. The effectiveness of i-Gen membrane and AnyRidge implant system to make the ideal ridge augmentation (I) By Dr Kwang-Bum Park DDÀ, Ph.D Visiting Fellow, ÀCÀA Dental Àchool, Periodontics Active Member, Academic of Osseointegration Ànt’l Member, American Academy of Periodontology Faculty Member, Harvard Àchool of Dental Medicine Flaps were elevated and various shapes of defects were exposed. Canine had a big socket with very thin labial cortical plate, the left central incisor showed a fenestration defect at the labial plate, and the right central incisor had labial and palatal plate losses. Àwo 15-degree Fuse abutments were connected with fixtures. After placement of a Flat abutment into the right central implant, the mixture of allogenic (Mega-Oss) and xenogenic (Mega-Oss Bovine) bone grafts was piled up on the defect to make ideal shape of ridge. An A1 type i-Gen membrane was placed on top of the Flat abutment and secured with a healing abutment. Àhis was an immediate implant placement case there was not enough soft tissue to make primary closure. Ào, a healing abutment is better than a cover screw for the soft tissue management. n aÀ