Socket rebuilding for immediate implant placement

Dr. Gerd Körner
Initial situation

A female patient (45 years old) shows a hopeless tooth with missing buccal bone

Used biomaterials
  • mp3®
  • Lamina®
1. Initial situation: extended combined perio-endo lesion 11, buccal wall missing

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

2. Initial x-ray examination 11: missing buccal wall plus vertical defect to the apex

3. Extraction of the multi-fractured tooth 11

3. Extraction of the multi-fractured tooth 11

4. 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

5. Periodontal probes to demonstrate the extension of the missing buccal bony wall

6. Placement of 4,2 mm ASTRA Profile next to the palatal wall, see the buccal deficiency

6. Placement of 4,2 mm ASTRA Profile next to the palatal wall, see the buccal deficiency

7. Inserting a defect related, folded Soft Cortical Lamina®

7. Inserting a defect related, folded Soft Cortical Lamina®

8. Soft Cortical Lamina® before insertion with indirect tunnel opening to help unfolding the inserted Lamina® on top of the defect borders

8. Soft Cortical Lamina® before insertion with indirect tunnel opening to help unfolding the inserted Lamina® on top of the defect borders

9. Cutting the Soft Cortical Lamina® according to a paper template matching the deficient bony wall

9. Cutting the Soft Cortical Lamina® according to a paper template matching the deficient bony wall

10. ASTRA Profile with cover screw to allow bone grafting of mp3® between implant and replaced buccal wall (Soft Cortical Lamina®)

10. ASTRA Profile with cover screw to allow bone grafting of mp3® between implant and replaced buccal wall (Soft Cortical Lamina®)

11. Additional grafting of a thin autogenous connective tissue

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

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

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

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

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)

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)

Used biomaterials
mp3
mp3®
lamina
Lamina®
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