Bilateral implant in the osteoporosis pt. Intra-bony and additional GBR. > DENTAL FORUMS

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This is the case more than 10 years ago.
66-year-old female,  Cleft Lip & Palate, Osteoporosis ; stop taking BSP, 2months before surgery.
<Jlon>


  Pt. was wearing dentures (Mx-full denture, Md-partial denture). Pre-op panoramic radiograph.


  photo on the day of implant surgery.


  The flap was opened and two implants were placed. Finally, it was decided on a 3-unit implant-supported fixed partial denture.


  suture.


   A panoramic radiograph after implant surgery.


  CBCT after 1 month of implant surgery.


  CBCT after 1 month of implant surgery. The lateral alveolar bone of the implant is thin.
 

  1 month after the implant surgery in the right mandible. Intraoral photo after anesthesia on the day of implant surgery in the left mandible.
 

   After drilling, only the cortical bone had resistance, and the inside was in a type 4 bone condition as if the bone was empty. (FDBA)
 

   After minimal drilling, the implant is inserted into the bone and compacted.
 

   The inside was too empty, so I filled it up by compacting the grafted bone in various directions using a parallel pin in the Ankylos surgical kit. 
 

   parallel pin.



  Ankylos Ø3.5/9mm,  5~10Ncm.
 

   intra-bony GBR.


  implant placement.



  suture


  panoramic radiograph.


  I had a longer wait than usual. This photo is 6 months after implantation. photo before 2nd surgery.



  As expected from CBCT, the remaining alveolar bone on the outside was thin.

   An additional GBR was performed. (xenograft-even after years, the grafted bone has the lowest resorption.)

   For the sutured area, collatape® is used for quick healing of the soft tissue.
 

  Suture.


  8 days after 2nd surgery.


   lab work.


  screw hole sealing


  Porcelain Fused to Metal crown.


  Left side,  2nd surgery.


  To create the desired gingival shape, find a healing abutment of an appropriate size and re-connect it.


  Lab work.


  Porcelain Fused to Metal crown.