Prof. Daniel Buser & Prof. Urs Belser (Berne, Switzerland)
Find the detailed
surgical
approach here.
1 2 3
4 5 6
7 8 9
10 a
10 b
11 a
1 C
linical findings in the initial examination. The patient exhibits
a high smile line and reports an accident several years ago,
which affected tooth 11.
2 T he extraction socket and the soft tissue are allowed to heal for
4–8 weeks after debridement of the inflammatory tissue.
3 W ithin 4–8 weeks of soft tissue healing, no reduction is visible in
the crest width in the approximal region of the socket.
4 Special attention is payed to correct prosthetic positioning of the
implant in all three dimensions with good primary stability.
5 T he defect is covered with locally harvested autogenous bone
chips to promote new bone formation as quickly as possible.
6 T he bone volume is further optimised by local augmentation using
Geistlich Bio-Oss ® granules.
7 G eistlich Bio-Gide ® is applied in two layers to act as a temporary
barrier and as a stabiliser for the graft.
11 b
Case documentation
12
8 F ollowing the release of the flap by means of mucoperiosteal
incisions, a tension-free primary wound closure is achieved. Provi-
sional implant prosthesis starts after 8 weeks.
9 T he 7.5-year follow-up shows a stable aesthetic outcome.
10 X-rays a) at 1 year: implant optimally integrated in the bone;
b) at 4 years: absolutely stable peri-implant bony conditions.
11 CBCT findings at 7.5 years a) section showing a completely intact
facial wall; b) 3-dimensionally correctly placed implant.
12 T he long-term aesthetic result is excellent.
Material selection
Geistlich Bio-Oss ® small
granules (0.25–1 mm)
Geistlich Bio-Gide ®
(25 × 25 mm)
12