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ePaper created 2017-12-06, 12:03:50 | version 1.38.0
| industry Fig. 7 Fig. 8 Fig. 7: Postoperative X-ray Reconstruction of a lateral wall after six months. Fig. 8: Postoperative X-ray after six years. Fig. 9: Follicular cyst region 23 at the retained and extremely removed tooth 23. Figs. 10 & 11: Filling of the defect A 52-year-old patient had a follicular cyst in re- gion 23 with a retained and displaced tooth 23 (Fig. 9). Because the patient wanted to replace the gap with an implant later on, a ridge preservation had to be performed. After osteotomy of tooth 23 and cystectomy an extensive bone defect was visi- ble, with a missing vestibular wall. The cover and re- construction of the vestibular bone was done with resorbable (PDLLA) pins and a resorbable (PDLLA) membrane. This created a possibility to fill the de- fect with -TCP granules soaked in blood (Figs. 10 & 11). Afterwards, the wound was closed with inter- rupted sutures (Fig. 12). The postoperative pano- ramic scan shows the filling of the defect radio- graphically (Fig. 13). with -TCP granules Augmentation of atrophied maxillary ridge soaked in blood. Fig. 12: Closing of the wound with interrupted sutures. Fig. 13: Postoperative panoramic scan showing the filling of the defect. Both materials are suitable for the internal and ex- ternal sinus floor elevation, however -TCP is pre- ferred for sinus lift procedures. When the bone defect is vestibular or the bone quality is poor, the applica- tion of hydroxyapatite is more advantageous. A 65-year-old patient presented with an extensive maxillary bone atrophy with loss of the teeth #14 to #16, #21, #22, #36 and #46 (Fig. 14). Firstly, a 3-D CT presentation of the jaws was made to determine the necessary bone augmentation. Afterwards, a sinus floor elevation on the right side was performed by means of balloon lifting technique. A sinus floor aug- mentation with combination of -tricalcium phos- phate and autologous bone was performed on the right side. Simultaneously, three implants were placed in the first quadrant with the help of a prefabricated guided-implant surgery template (Fig. 15). In the second quadrant, a massive lateral bone augmentation had to be performed, otherwise, the implants in the vestibular cranial direction would not have been covered by bone tissue. For prosthetic reasons, no other position could be chosen for the implants. After implant insertion with CT templates in region 21 and 22, the lateral bone augmentation was effected with a compound of -TCP and autol- ogous bone and a resorbable membrane was used for coverage (Fig. 16). Fig. 9 Fig. 13 Fig. 10 Fig. 11 Fig. 12 40 implants 4 2017