GAP Australasian-Dentist-May June 2019

Category 44 AustrAlAsiAn Dentist Case: 63-year old male patient. Non-smoker. non-restorable upper right central incisor. tooth mobility grade 3, marked soft tissue recession, periodontal abscess, and displacement of the tooth due to severe bone loss (Pics 1-3). According to protocol (Fairbairn and leventis 2015) the tooth was “atraumatically” extracted without raising a flap and the site was thoroughly debrided with hand lucas curettes and ethOss degranulation burs. (Pic 4). After extraction, a severe buccal hard and soft tissue defect was evident (Pic 5). the site was left to heal spontaneously under secondary intention. After 6 weeks, the area was covered by newly-formed soft tissues (Pic 6). A site-specific, papilla-sparing, full-thickness flap was raised, revealing a large 3- wall bony defect. the buccal bone was completely missing. A 3.75x11.5 implant (Paltop Advanced) was placed in the optimal 3D position (Pics 7,8). the area was subsequently grafted with 0.5cc self-hardening –tricalcium Phosphate/Calcium sulfate – ethOss (Pic 9). After 12 weeks, the implant was exposed and a healing abutment was placed. A screw retained implant crown was fitted. At follow-up 10 months post-operative, the architecture and the volume of the ridge had been successfully restored and the area buccally was covered by thick regenerated keratinized soft tissues (Pics 11,12). A CBCt at this point showed that the buccal bone was successfully regenerated (Pic 13). u From missing buccal bone to successful regeneration and implant placement lInICal By Dr Minas Leventis DDs, Msc, PhD Dr Minas Leventis is currently Research Manager at EthOss Bone Regeneration. Minas is also on the faculty of the Dental School, University of Athens, as a visiting Clinical Instructor and Researcher, where he teaches under and post-graduate students Exodontia, Oral Surgery, Bone Grafting and Implantology, while undertaking extensive experimental research. Pic 1 Pic 4 Pic 7 Pic 10 Pic 12b Pic 13 Pic 2 Pic 5 Pic 8 Pic 11 Pic 3 Pic 6 Pic 9 Pic 12a