GAP Australasian Dentist Mar Apr 2020

Category 70 Austràlàsiàn Dentist Stability without membranes, 2019 Case performed by Dr Michael Ainsworth, àK Figure 1. Initial situation. Periapical radiograph showing resorption. Figure 5. Two weeks following extraction – CBCT image of the extraction socket. Figure 9. Implant placed in ideal position for cement-retained prosthesis. Figure 13. After two weeks healing. Figure 3. Atraumatic extraction leaving the socket epithelium intact. Figure 7. Palatal defect repair with EthOss®. Figure 11. Placement of a “wetter” mixture of graft material in stages under the dome device, carefully drying and compressing with each stage. Figure 15. Probing the distal of tooth 12 shows 1 mm pocket depth indicating adequate healing response. Figure 2. Examination revealed deep pocketing of up to 9mm mesially, grade 2 mobile, adjacent tooth grade 1 mobile and had pocket depth of 5mm distally. Figure 6. Four weeks following extraction – surgery, flap raised, completion of degranulation. Figure 10. Placement of 2-0 PDS tenting sutures to create “dome device” to help prevent micromovement of the graft material. Figure 14. Twelve months control, following crown cementation. Figure 4. Maryland bridge, note close adaption and support of the socket periphery. Figure 8. Implant placement with 2 mm cover screw. Figure 12. Control radiograph at twelve weeks healing. Figure 16/17. Final tissue maturation at twelve months, shows stippling, contour and volume consistent with underlying bone health. àntraoral host bone regeneration may be affected by the pressures of the soft tissue as well as frenal muscle forces. ào overcome these effects, many different methods have been employed including tenting screws, titanium meshes, autogenous plates (Khoury) and titanium reinforced membranes to maintain the space below the periosteum to the bone. àhis case report shows an interesting technique utilising “dome device” sutures to aid graft stabilisation. Background 73 year old patient, male. àon-smoker. Pain from a mobile upper right central incisor that had received trauma approximately ten years prior to presentation. u See http://ethoss.dental for more clinical information and join the conversation on Facebook @ EthOss Case Studies àlàn al