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ePaper created 2016-11-23, 14:26:06 | version 1.38.0
| industry 22 implants 4 2016 Although no vestibular fenestration was ob- served at the time of surgery, it was decided to in- crease the vestibular cortical bone thickness, since some portion of this bone is usually resorbed after implant placement. First, the resorbable membrane was stabilised lingually and, after filling the relevant zone with heterologous bone, the membrane was folded down on the vestibular side to protect the graft (Figs. 10 & 11). The surface of the membrane was then disinfected with a 0.2 % chlorhexidine solution, and the flap was closed passively in order to obtain a first degree clo- sure without traction on the suture (Figs. 12 & 13). Two lines of sutures were executed, the first with horizontal external mattresses, later stabilised by a second line of separate points more coronal to the first(Fig.14).Thepatientwasdischargedwiththefol- lowing drug regimen: rinses with 0.12 % chlorhexi- dinediclugonatefor60secondstwiceaday,antibiotic therapy with amoxicillin and clavulanic acid—one tabletof875 mgtwiceaday,iceonthefirstdayanda semiliquiddietforthefirstweek.At15daysaftersur- gery, follow-up was performed to verify the healing of the tissues (Fig. 15). After removal of the suture, the site did not show signs of dehiscence of the wound (Fig. 16). The suc- cessful osseointegration of the implant is visible on the four-month follow-up X–ray and all tissues ap- pear to be well healed (Figs. 17 & 18). A healing abut- ment was then inserted (Fig. 19). Outcome The case will be finalized and updated in the next few months with the delivery of the final prosthetics to the patient._ Acknowledgement: Thanks to Dott. A. Carenzo & E. Carenzo from Vercelli. Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Figs. 12 & 13: Release of the flap and primary intention closure. Fig. 14: Suture. Fig. 15: Suture follow-up at 15 days. Fig. 16: Suture removal at 15 days. Figs. 17 & 18: X-ray and tissue healing after four months. Fig. 19: Healing abutment. contact Dr Paolo Borelli Paolo Borelli clinic, Turin, Italy paoloborelli@alice.it Dr Massimiliano Favetti Dentamed clinics Rome, Italy massi@dentamed.it Author details Author details Literature Fig. 12 Fig. 13 42016