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Pierre-Marc Verdalle

Bordeaux, France

Clinical case description:

The patient presents a root fracture on his lower right canine. His first premolar is missing.

The 3D CT scan reveals a loss of buccal cortical bone on the canine, and a horizontal bone defect on the premolar.

The selected treatment plan is :

1. Extraction of the canine and concomitant GBR for both canine and premolar.

2. Delayed implantation (6 months).

After canine extraction, a flap is elevated and managed to preserve the alveolar nerve. GBR was conducted using Geistlich Bio-Oss® and a Geistlich Bio-Gide® membrane fixed with pins. These pins improve the membrane’s stability, especially in the apical zone, when suturing the flap to cover the graft.

A control radiograph showed at 6 months enough bone augmentation to place 2 implants.

The prosthetic restoration (2 metal-ceramic crowns on customized abutment) was finalized 2 months after implant surgery.

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<p>Initial bone loss</p>

Initial bone loss

<p>Membrane fixed with pins covering Geistlich Bio-Oss<sup>®</sup></p>

Membrane fixed with pins covering Geistlich Bio-Oss®

<p>2 implants placement at 6 months pos-operative</p>

2 implants placement at 6 months pos-operative

<p>Soft tissue thickness befor crowns placement</p>

Soft tissue thickness befor crowns placement

Pre-surgery


					<p>Initial bone loss</p>

Surgery


					<p>Membrane fixed with pins covering Geistlich Bio-Oss<sup>®</sup></p>

Outcome


					<p>2 implants placement at 6 months pos-operative</p>

Follow-up after at least 6 months


					<p>Soft tissue thickness befor crowns placement</p>