A new case by our Group Expert Dr. Vincenzo Vitale for the SIPROunder 40 contest.
Patient, female, 63 years old.
Comes to my observation requesting the restoration of partial edentulism in zone 1.4.
The patient says that the tooth, lost a few months earlier, had been suffering from significant mobility for some time.
The element then suddenly suffered a spontaneous avulsion.
Clinically and radiographically, a residual vestibular defect post spontaneous avulsion appears evident.
The patient requires an implant solution.
The medical history shows no pathologies or contraindications to implant therapy.
The treatment involves performing a horizontal GBR to restore adequate bone volumes for implant insertion. Subsequently, once maturation has occurred, the implant will be inserted and a screwed zirconia crown will be created.
After local profund anesthesia, a full thickness trapezoidal flap is prepared.
For the bone graft, deproteinized bovine heterologous biomaterial is used. This is hydrated with sterile saline and the patient’s blood taken from the site. The bone defect is filled with the biomaterial and, above, a reabsorbable collagen membrane is placed. The latter is modeled and inserted like an envelope between the palatine and vestibular flaps. It is then stabilized with absorbable sutures on the palatal side. We then proceed to passivize the flap by cutting the vestibular periosteum and to close, by primary intention, the site with PGA sutures.
Before closing, equine collagen is placed on the occlusal side and pressed between the membrane and the flap.
At 5 months the site appears voluminous and ready to receive the implant. We then proceed to insert the implant (conical connection) with healing screw.
After 3 months of waiting, the final impression is taken and the screwed zirconium crown is delivered.
When controlling the element, it provides good integration and the volumes of the hard and soft tissues are satisfactory.
