Dr. Luca Cordaro (Rome, Italy)
“Early implantation with simultaneous contour
augmentation is predictable in challenging
cases in the aesthetic zone.”
Case documentation
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1 Initial situation before extraction of 21 and 22.
2 Clinical close-up of the pre-operative site prior to extraction of
the teeth.
3 a) Radiographic findings of the pre-operative site. Note the apical
bone resorption at 22 and internal root resorption of tooth 21.
b) Scheme of the 2 side-by-side sockets.
4 Teeth 21 and 22 are extracted and left heal spontaneously under
a provisional restoration.
5 B uccal view after 6 weeks of spontaneous healing. Immediately
before re-entry. Note the flattening of the ridge anticipating
a horizontal defect.
6 Occlusal view 6 weeks post-extraction. The soft tissues are healed.
7 After flap elevation and implant placement, the resorption of
the alveolar bone is compensated with Geistlich Bio-Oss ® .
8 G eistlich Bio-Gide ® is placed over the treated area to stabilise
the graft and to obtain the desired contour augmentation.
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9 Healing of the treated site 18 weeks post-extraction.
10 O ccusal view after 18 weeks. Transmucosal healing took place with
conditioning of the soft tissues with the provisional crown. The
recession on tooth 23 has been covered with a coronally advanced
flap and a connective tissue graft.
11 a) X-ray of the final prosthetic restoration. b) Schematic represen-
tation of the cantilever implant bridge.
12 Final situation with the cantilever implant bridge in place
5.5 months after tooth extraction.
Material selection
Geistlich Bio-Oss ® small
granules (0.25–1 mm)
Geistlich Bio-Gide ®
(25 × 25 mm)
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