Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-10-04, 09:33:57 | version 1.38.0
| cone beam supplement case report 50 CAD/CAM 3 2016 Localized ridge augmentation utilising titanium mesh with CPS morsels and simultaneous implant placement—A case report Implantplacementintheatrophicanteriormaxilla can often be a difficult task due to deficient bone height, width, and volume. Many procedures have been introduced to aid in the reconstruction of the maxillary alveolar ridge to gain adequate bone to enable implant placement. Surgical modalities for alveolar ridge augmentation, along with guided boneregeneration,hasbeenproventobesuccessful in re-establishing an appropriate alveolar ridge width. Guided bone regeneration is generally ac- complished with the use of particulate bone of various types, and this bone is often protected by membranes. It has been found that the quantity of bone regenerated under the membranes has been demonstrated to be directly related to the amount of the space under the membranes. This space can diminish if the membrane collapses or is com- pressed, resulting in a less than satisfactory treat- ment outcome. To avoid the potential problem of membrane collapse, a technique of ridge augmen- tation is described, which involves the use of a rigid titanium mesh barrier to protect the regenerating tissues and to help protect the underlying bone segments. In this case report, excellent results were demonstrated for a maxillary anterior defect, augmented using guided bone regeneration with simultaneous placement of an implant to replace the maxillary right central incisor tooth particulate bonegraftmaterialprotectedbytitaniummesh.The use of CBCT was essential for the pre-operative di- agnostics and useful for demonstrating the volume gain in the post-graft assessment of the site. Introduction Resorption of the edentulous or partially edentu- lous alveolar ridge or bone loss due to periodontitis or trauma frequently compromises dental implant placement in a prosthetically ideal position. These deformities can lead to complications in attempts for the restoration of related areas. Therefore, aug- mentation of an insufficient bone volume is often indicated prior to, or in conjunction with, implant placement to attain predictable long-term func- tioningandanaesthetictreatmentoutcome.1 Inre- centyears,therehasbeenanincreaseinthenumber of studies focusing on the augmentation of these atrophic ridges either before or at the time of im- plant surgery.2–6 Predictable bone regeneration of large alveolar defects with complex morphology can pose a significant clinical challenge. Preserva- tion or creation of a soft tissue scaffold needed to create the illusion of a natural tooth, or root emi- nence for an implant supported restoration is often challenging and difficult to achieve.7 A subtle mistakeinthepositioningoftheimplantorthemis- handling of soft or hard tissue can lead to aesthetic failure and patient dissatisfaction.8–10 Autogenous bone grafts are considered by many to be the gold standard in bone regeneration pro- cedures.11 However,donorsitemorbidity,unpredict- ableresorption,limitedquantitiesavailable,andthe Fig. 1: Loss of maxillary right central incisor. Authors: Drs. Lanka Mahesh, Gregori M. Kurtzman, Dildeep Bali, Vishal Gupta & Taran Preet Singh, USA & India Fig. 1 32016