CAD/CAM international magazine of digital dentistry

Fig. 11a_Membrane exposure of the non resorbable ePTFE membrane after 4 weeks. Clearly visible is the enhanced soft tissue situation. Fig. 11b_6 months post surgical the fully reconstructed bone situation is obvious. Fig. 12a_CBS of the pre-op region 44 with entire loss of the buccal plate in region tooth 44. Fig. 12b_Region tooth 44 after 6 months of healing with fully reconstructed bone prior to implant surgery. Fig. 13_Inserted implants in the fully reconstructed bone. material and was instructed to have no solid food for 10 days. Postoperative the patient contin- uedwith1,800mgClindamycin,Ibuprofen600mg and a decongestant enzyme based medicine (Bromelain-Pos®, Ursapharm, Germany). The next day the patient had an expected cheek swelling but was not suffering from pain, after 10 days the sutures were removed. However, 6 weeks later a membrane exposure of the non resorbable mem- brane was evident, but due to the fact that this is tollerable when the patient is instructed to main- tainoralhygieneandre-calledonceaweek,thesuc- cess of the outcome was not threatened (Fig. 11a). The titanium pins and the titanium reinforced membranes were removed after 4 months. Eightmonthsafteraugmentationthe2-Daspect of the CBVT showed clear evidence for entire ridge reconstruction of the deficient sites (Fig. 11b) with osteosynthesis screws in position. To emphasize the efficiency and predictability of this technique the pre-op scan of region 28 (Fig. 12a) and the re- constructed bone 8 months later (Fig. 12b) show clear an increasement of bone height and width. The well vascularized bone was used to insert 4 dental implants (4 x 3.75 x 13 BEGO Semados®, BEGO, Germany) for a later bar-retained denture, thehealingtimeisestimatedwith8weeks(Fig.13) and was not completed before publication, here my apologies to that. _Discussion 3-D bone augmentation in cases with severe bone loss can be accomplished also with a less invasive surgical protocol than the iliac hip graft. Themorbiditycanbedramaticallyreducedwiththe useofultrasonicdevices.Regardingthedonorsite, whichmaybefavorizedwiththeretromolarregion patients have close to zero complains if a single incision procedure is performed. Allograft materi- als may enlarge the volume of the augmentation material and in addition to that the success of -TCP is not to be questioned. Regarding the long term stability the regener- atedboneissuperiortopureautologousbonefrom theiliaccrest,whichresorptionrateismuchhigher compared to intraoral bone or -TCP. Reduced pain and postoperative complains should be re- duced and enlarges the number of patients willing to undergo oral augmentative procedures. _ I user report _ alveolar ridge reconstruction 26 I CAD/CAM 3_2012 Fig. 12a Fig. 12b Prof Marcel A.Wainwright DDS,PhD Dentalspecialists Kaiserswerther Markt 25–27 40474 Duesseldorf,Germany Weinrecht@aol.com www.dentalspecialists.de Universidad de Sevilla Facultád de Odontologia CalleAvicena s/n 41009 Sevilla CAD/CAM_contact Fig. 11bFig. 11a Fig. 13