Vertical and horizontal reconstruction of the esthetic area

1. Initial situation patient with upper RPD willing to have a fixed upper restaurations on implants

2. Full contour wax-up demonstrating the horizontal and vertical bone loss deficiency on posterior areas

3. Virtual representation of the full contour wax-up and the presence of the defects

4. From left to right implant placement N1 Nobel Biocare plus screwed hard Tecnoss® Lamina® plates and 50% autogenous bone + 50% xenogenic bone material (OsteoBiol® Apatos®)

5. From left to right, day 0 of the surgery to 6 months. We can appreciate the nice integration of the Tecnoss® Lamina® into the grafted bone

6. Panoramic x-ray of the osseous surgery

7. Crestal tuberosity connective tissue graft + connection of multiunits and corresponding healing abutments

8. Provisional restoration connection. Notice the absence of keratinized mucosa and the incisal position of the mucogingival line on a high lip smile line

9. The strip gingival autograft technique was selected in order to blend the gingival color with the rest of the soft tissues in conjunction with xenogenic collagen matrix OsteoBiol® Derma

10. The strip gingival autograft technique was selected in order to blend the gingival color with the rest of the soft tissues in conjunction with xenogenic collagen matrix OsteoBiol® Derma. Occlusal view.

11. The strip gingival autograft technique was selected in order to blend the gingival color with the rest of the soft tissues in conjunction with xenogenic collagen matrix OsteoBiol® Derma

12. Final zirconia screw retained Nobel Biocare Procera implant bridge with corresponding x-ray

13. Initial situation, before treatment

14. Final result

15. Smile before surgery

16. Smile after surgery