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CAD/CAM – international magazine of digital dentistry No. 3, 2017

use of CBCT cone beam supplement | Fig. 2a Fig. 2b the width was given by the gingiva, not by the bone. This was one of these cases, but fortunately I realised it before the surgery. The analysis of the CT scan showed that the bone width of the crest was only 2 mm (Figs. 2a & b). It was obvious that the bone regeneration was needed. Taking into account the high aesthetic expecta- tions of the patient and dimensions of the bone de- fect, I didn’t want to risk one stage surgery (which I planned initially, before I saw the CT scan). I decided to do a bone augmentation first and insert the implant after a few months of healing. I planned to regenerate the bone horizontal and a little bit vertical, with BioOss and BioGide (Geistlich) mixed with autologous bone harvested from the nasal spine. Surgical procedure I am not exaggerating when I say I have seen thou- sands of patients before surgery, many of them were very nervous, and anxious about what was going to happen. Therefore, I was astonished seeing this young patient calm even when I was explaining to her the steps of the surgical procedure. Moreover, she wanted to know everything about guided bone regeneration, xenograft, allograft, palatal bone augmentation, implant insertion and gingival graft. Truly surprised, I asked her why she wanted to hear all the details—was she afraid? But then she said: ‘How could I be afraid? I've been waiting for more than four years! I'm here to take back what I lost a long time ago, so let's do it!’ Fig. 3a Fig. 3b Fig. 3c Fig. 3d CAD/CAM 3 2017 47

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