Indication 8, Case 4 | ITI CENTER

Implant placement with a simultaneous GBR procedure.

Restorative Dentist:
Prof. Dr. Daniel Buser
Dept. of Oral Surgery
University of Berne, Switzerland

	Single tooth gap in the right maxilla. The first premolar was lost due to an endodontic failure. The tooth was removed and the soft tissue were allowed to heal 3 months. Please note the gingival recession at the adjacent canine.

	Intrasurgical status following elevation of a full-thickness flap and placement of a standard ITI screw implant (S 4.1). A mid-size crestal bone defect is apparent on the buccal aspect. The bone defect has a favorable defect morphology with two bone walls, and the exposed implant surface is located inside the bony envelope.

	Autogenous bone chips - locally harvested in the periimplant area with a chisel - are used to fill up the bone defect.

	The autografts are superficially covered with bone slurry collected with a filter during preparation of the implant recipient site.

	The graft material is covered with a collagen membrane (BioGide®). The membrane is soaked in blood. With this procedure, the membrane is getting sticky and will stabilize itself on the bone surface underneath.

	The collagen membrane is covered with a second layer of the membrane. This double layer technique improves the stability of the applied barrier membrane. A membrane fixation with pins is not necessary.

	Following incision of the periosteum, the wound is closed with a coronally displaced full thickness flap. This technique allows a tension-free tissue closure.

	Clinical status 3 months following implant placement: Primary soft tissue healing is achieved.

	Clinical status following reopening of the implant site with a punch biopsy

	Clinical status 1 year following implant placement with an esthetically pleasing implant borne crown. The gingival recession of the canine has been clearly reduced.

	The periapical radiograph demonstrates normal periimplant bone structures.