IMPLANT TOGETHER WITH BONE GRAFT

This patient's lower right molar had to be removed due to severe chronic periodontitis and loss of supporting bone. After one month, after the mucosa had overgrown the socket a bit, we inserted the implant the following way:-
  1. We drilled right through the mucosa in a flapless procedure until we hit paydirt.... I mean bone. Unfortunately the first drill went right into the inferior dental canal and there was a gush of blood. The bleeding was stopped with a piece of spongostan and biting on a piece of gauze.
  2. After another 2 months, we went in again flapless again, this time more carefully in avoiding penetration of the inferior dental canal. After tapping the osteotomy and trying in the implant to its full depth, we removed it and made a straight incision along the direction of the alveolar crest.
  3. After lifting the flap bucally and lingually, we curetted the socket thoroughly to gain a raw fresh bony surface. 
  4. We then removed any loose granulation tissue attached to the flaps, screwed in the implant 4.5 by 11mm Ankylos. Bio-Oss was used to fill up the gaps 360 degrees around the implant. No membrane was used. Primary closure was achieved.
Because of some general health issues, we could not complete the case sooner. After almost one year, we screwed on the abutment, cemented on the crown and took an Xray and we had the pleasant surprise of seeing the bone graft substantially replaced by well calcified bone to the maximum level available!!!!!








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