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    • Socket rebuilding for immediate implant placement

    • cover image
    • 1. Initial situation: extended combined perio-endo lesion 11, buccal wall missing
    • 2. Initial x-ray examination 11: missing buccal wall plus vertical defect to the apex
    • 3. Extraction of the multi-fractured tooth 11
    • 4. Extraction of the multi-fractured tooth 11
    • 5. Periodontal probes to demonstrate the extension of the missing buccal bony wall
    • 6. Placement of 4,2mm ASTRA Profile next to the palatal wall, see the buccal deficiency
    • 7. Inserting a defect related, folded soft bone Lamina
    • 8. Bone Lamina before insertion with indirect tunnel opening to help unfolding the inserted Lamina on top of the defect borders
    • 9. Cutting the soft bone Lamina according to a paper template matching the deficient bony wall
    • 10. ASTRA Profile with cover screw to allow bone grafting of mp3<sup>®</sup> between implant and replaced buccal wall (bone Lamina)
    • 11. Additional grafting of a thin autogenous connective tissue
    • 12. Replacing the cover screw by an adequate healing abutment to support the new bony wall and the connective tissue
    • 13. X-ray after 4 months post-op at impression taking
    • 14. CBTC 6 months after prostho-delivering to demonstrate the new bony buccal wall
    • 15. 1 week post-op with provisional in place to condition the soft tissue profile
    • 16. Final situation 6 months after ceramic restoration of the upper front #13-#23 (full ceramic: #12, implant #11, #21 ceramic veneers: #13, #22, #23)
    • Clinical indication: horizontal augmentation
    • Products : Lamina, mp3®
    • Authors : Dr. Gerd Körner
    • Information about patient: Female, 45 years old
    • Credits : Documentation provided by Dr. Gerd Körner, Bielefeld, Germany
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