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ePaper created 2014-11-07, 14:16:52 | version 1.30.01
research I graft(Fig.26)andperformingbuccalrelievinginci- sions (Fig. 27) with resuturing afterwards (Fig. 28). However, this led to a larger exposed surface of the NanoBone graft (Fig. 29) owing to subsequent flap necrosis. The NanoBone graft had to be removed completely owing to infection and the result was a total graft failure. AninfectedNanoBonegraft(Fig.30)wastreated by incision and pus drainage (Fig. 31 a&b). The NanoBone graft healed but decreased in size (Fig. 32). _Conclusion Careful patient follow-up after ridge augmen- tationusingaNanoBoneblockisveryimportantfor the success of the augmentation procedure. Great attentiontodetailandameticuloustechniquemay prevent the progression of complications to failure of the graft. Treatment of a bone block graft ex- posed in the early stage is very difficult and has a poor prognosis. To date, there is no predictable method for treating this type of complication. Re- suturing the dehiscent area at an early stage can lead to an even larger exposed surface of the graft owing to subsequent flap necrosis. Therefore, it is better to wait until the soft tissue matures. During this time, the use of a chlorhexidine solution sev- eral times a day can be useful in reducing bacterial infiltration. After a period of at least four weeks, surgical closure can be performed after reducing the volume of the block graft. However, the proba- bility of saving all or parts of the graft is very low.5 Editorial note: This is the second part of a two-part arti- cle, the first of which was published in implants 1/14 (“Ridge augmentation for an atrophied posterior mandibleusingNanoBoneblock”).Acompletelistofref- erencesisavailablefromthepublisher. I 23implants3_2014 Dr Omar Soliman PhD Candidate Perioimplant Dentistry Tel.:+20 1009634358,+20 1201005457 Omar.Soliman77@yahoo.com Prof.Dr Dr Mohamed Nassar Professor of Perioimplant Dentistry Faculty of Dentistry,Tanta University,Egypt Tel.:+20 1121522221 prof_mnassar@yahoo.com _contact implants AD Hand in your article. Editorial manager Georg Isbaner g.isbaner@oemus-media.de Editor Katrin Maiterth k.maiterth@oemus- media.de Please contact: [PICTURE: ©SERGEY NIVENS]