GBR with CTi-membrane in the narrow ridge in mandible

Pre-operative

Clinical photograph of right posterior mandible and panoramic radiograph. Severe bone resorption is observed.

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After flap reflection, buccal bone deficiency was observed.

A cortical tap was used for coronal cortical bone to obtain passive, maximum contact between the cortical bone and implant.

#45 – IS-III Ø4.0x8mm, Neobiotech #46 – IS-III Ø5.0x10mm, Neobiotech #47 – IS-III Ø5.0x8mm, Neobiotech

Three implants were placed at the site of #45, 46, 47. The fixtures were placed in the positions as planned with VARO Guide planning software.

Autograft bone was harvested using ACM drill.

Bone graft material was covered and secured by Cti-membrane.

The flap was closed with tension-free suture.

No membrane exposure during 4 months of healing period

Removal of CTi-membrane during 2nd surgery

Healing abutments were tightened before closure.

Complete soft tissue healing was noted at the time of final impression.

SCRP crowns were fabricated and pink porcelain was used to reconstuct gingival architecture around #45, 46, 47.

Post-delivery Panoramic view

3 month follow-up

3 month F/U periapical view

10 month post-op. No significant clinical change is noticed.

10 month F/U panoramic view