implants - international magazine of oral implantology

1.Preparationforatightclosure After gentle and non-traumatic extraction of the non-conservable tooth, the marginalgingivaisminimallydetachedtothealveolarprocesssothatthefreemem- brane side of the collagen membrane and cone unit can be inserted. 2.Customisingcollagenmembraneandconeunit Moistening is to be avoided because this would make it more difficult to achieve a good fit to the alveolus. Rather, the collagen cone is fitted to the alveolus with the scalpel,andthemembraneisconfiguredwithsmallscissorstofacilitateinsertionun- der the marginal edges, while at the same time achieving an ideal defect-congruent coverage.Toachievethis,thedimensionsofthemembraneshouldbeapproximately 1–2 mm wider than the diameter of the alveolus. 3.Insertionofcollagenmembraneandconeunit Using dry, anatomical, wide tweezers, the collagen membrane and cone units are insertedintothealveolusandthenpushedindeepwithamoistswab.Themembrane part should be seated exactly at the level of the marginal gingiva. Now the free and slightly oversized part of the membrane is pushed carefully under the edges of the marginal gingiva. 4.Protectivemeasures A back-and-forth suture with a non-absorbable suture material will secure the position of the collagen membrane and cone unit in the alveolus and also adapt the free gingiva edges on the membrane. _Case presentations The following three patient cases serve to illustrate and ultimately evaluate the procedureofadelayedimmediateimplantationusinganabsorbablecollagenmem- brane and cone unit. Case1:Fournon-conservableteethintheanteriormaxilla Duetoatraumaoftheanteriorteethduringadolescence,thepatientreceiveden- dodontictreatmentandcrownsonthefourfrontteeth,which—afterrecurringprob- lems—resultedinapicoectomies.Thesecondsetofcrownsattenyearsafterthefirst prosthetic treatment was followed immediately by a second resection due to per- sistent discomfort. The patient is in her late thirties, and now the four front teeth 12, Degradable Solutions AG A Company of the Sunstar Group Wagistrasse 23 CH-8952 Schlieren/Zurich www.easy-graft.com Ingenious: Simple handling and accelerated osteocon- duction for long-term volume preservation. easy-graft® CRYSTAL bionicstickygranules AD Fig. 2k Fig. 2l Fig. 2m Fig. 2n