Dental Implant in the esthetic region following autogenous block graft

Dental Implant in the esthetic region following autogenous block graft

Age: 22                                                               Gender: Female

Type of Case: Dental implant in the esthetic region following autogenous block graft.

Chief Complaint: Patient complained of missing upper front tooth.


Dental History:

  • History of trauma wrt 11 five years ago followed by extraction of the same.
  • Undergone Orthodontic treatment and root canal treatment.
  •  Both the treatment was carried out in a private setup elsewhere.

Pre Operative:

Clinical Findings:

  • Missing  11, deficient buccolingual bone width in the same region.
  • Root canal treated 17,16,36.
  • Fixed orthodontic retainers in the lower arch.
  • Missing teeth were replaced temporarily using resin-bonded prosthesis during orthodontic treatment.

Alternative Treatment Plan:

  • Fixed partial denture wrt 12,11,21.
  • Removable partial denture wrt 11.
  • Resin bonded prosthesis

Treatment Plan:

  • Autogenous bone grafting wrt 11 region.
  • Followed by the replacement of the missing tooth by a dental implant.

During the procedure:

Treatment Procedure:

  • A diagnostic CBCT was obtained and studied. Diagnostic models, preoperative photographs, radiographs were made. A mock-up was performed on the models.
  • The patient was scheduled for the surgery. The recipient site was prepared. Donor site, the parasympyhsis region of the mandible was exposed and two rectangular cortical blocks were harvested. The donor site was grafted using PRF, xenograft and the area was sutured back. The harvested blocks were adapted and fixed onto the labial aspect of the upper anterior region using plates and screws. The graft was completed using some particulate xenograft and a GTR collagen membrane. The area was sutured and secured. The temporary resin-bonded prosthesis was given to replace the missing tooth. Postoperative instructions and medications were given.
  • A month later the upper orthodontic brackets were debonded and a fixed retainer was given. Crowns were fabricated for 26,27.
  • Six months following the surgery, clinical examination and radiographs were made and it showed good acceptance of bone graft and esthetic appearance. A dental implant was placed in the region to replace 11 and left to heal for 3 months.
  • Following which, Second stage surgery was done and temporary crown modified accordingly. Final impressions were made in 2 weeks following the second stage surgery. A bisque trial was done and found satisfactory. The final screw-retained prosthesis was delivered, and weeks follow up has been carried out.

Post Operative:

Follow Up:

  • A regular 6 months follow up is advised.

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