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implants the journal of oral implantology United Kingdom Edition

I 43 case study _ Implant therapy I implants2_2012 ing were scheduled biweekly for the first six postoperative weeks. Prior to tooth extraction each patient received a resin bond prefabricated bridge to provide immediate provisional prosth- odontics reconstruction after tooth extraction. Finally all patients received fixed prosthodontic restoration ie PFM crowns on each implant. _Case 1 (Figs. 1–14) A 51-years-old male patient was re- ferred with generalised periodontitis for a comprehensive periodontal treatment. At the upper right lateral incisor an ad- vanced periodontal defect was regis- tered with tooth mobility III. Deep peri- odontal pocket depths were assessed on the adjacent teeth. After flap elevation a two-wall crater-like defect was found on the mesial aspect of the tooth with a missing buccal bony plate. After tooth extraction the previously described step- by-step technique was carried out. As a result of surgery 1, completed with a soft tissue augmentation, the alveolar ridge configuration allowed the implant place- ment with simultaneous further aug- mentation. During abutment connection the 3-D reconstruction of alveolar ridge was observed around the previously su- pracrestally placed implant. This surgical approach allowed a re-entry procedure of adjacent periodontal defects, they presented bone fill and complete regen- eration of earlier one-wall defects. After soft tissue healing a screw retained tem- porary crown was placed in situ to form an ideal emergence profile for further three months. This situation was then transferred to the cast to make the per- manent PFM crown. _Case 2 (Figs. 15–17) A 54-year-old male patient presented an advanced vertical bony defect on the mesial aspect of the right upper central incisor with excessive tooth mobility. Af- ter tooth extraction an alveolar site de- velopment was performed in the same way like described before without any bone substitute material. The second sur- gical phase was the previously described soft tissue augmentation. During surgery 3 implant placement with simultaneous hard tissue augmentation was proceed- ed by. As an augmentation material BDX was used covered by a slow resorbable membrane. The width and height of the alveolar ridge became sufficient to pro- mote long term stability for the implant borne restoration. _Case 3 (Figs. 18–20) The third case is a 49-year-old male patient who presented the left upper lateral incisor with an advanced hori- zonto-vertical bony defect on its mesial aspect. Following tooth extraction an Fig. 16a Fig. 16b Fig 16 a&b_The optimally positioned implant in 3-D regenerated bone. .