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Gonçalo Assis

Lisbon, Portugal

Clinical case description:

68 year old female patient feeling discomfort and bleeding during brushing and acute pain during mastication on a lower premolar. After clinical and radiographic examination, showing a deep infrabony defect on the mesial aspect of the premolar compromising both this tooth and the adjacent canine, a diagnosis of complete tooth fracture was established and the tooth programed for extraction. Because of the demanding environment for immediate implant placement due to scarce bone availability resulting from the fracture, a staged regenerative approach was indicated using GBR techniques with Geistlich biomaterials. The procedure had the objective of not only providing enough bone for adequate implant placement but also to regenerate the periodontal apparatus of the adjacent tooth.

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<p>Fracture of lower premolar and resulting periodontal pocketing and bone defect</p>

Fracture of lower premolar and resulting periodontal pocketing and bone defect

<p>Guided Bone Regeneration using Bio-Oss<sup>®</sup> Collagen and Geistlich Bio-Gide<sup>®</sup></p>

Guided Bone Regeneration using Bio-Oss® Collagen and Geistlich Bio-Gide®

<p>Primary closure using double papilla lingual flap and radiograph showing complete bone defect filling</p>

Primary closure using double papilla lingual flap and radiograph showing complete bone defect filling

<p>CBCT showing good bone healing after 6 months, implant placement with good primary stability and immediate healing abutment</p>

CBCT showing good bone healing after 6 months, implant placement with good primary stability and immediate healing abutment

Pre-surgery


							<p>Fracture of lower premolar and resulting periodontal pocketing and bone defect</p>

Surgery


							<p>Guided Bone Regeneration using Bio-Oss<sup>®</sup> Collagen and Geistlich Bio-Gide<sup>®</sup></p>

Outcome


							<p>Primary closure using double papilla lingual flap and radiograph showing complete bone defect filling</p>

Follow-up after at least 6 months


							<p>CBCT showing good bone healing after 6 months, implant placement with good primary stability and immediate healing abutment</p>