Staged approach utilizing CTi membrane to regenerate moderate ridge defect on #23

This case done by Dr. Yong Soo Kim shows successfully placed Neobiotech IS II implant on the site 23 with a CTi-membrane.

Introduction

1. Moderate alveolar ridge defect in anterior area is a challenge to restore esthetically with dental implants due to it’s lower bone regenerative potential. 2. CTi membrane is a useful material when the defect morphology is not favorable.

Panoramic X-ray show significant amount of alveolar bone resorption around #23

CT scan shows both vertical and horizontal defect around #23

Treatment Plan

1. Scaling and root planing 2. #23 extraction 3. #23 GBR with CTi membrane 4. #23 Implant placement and restoration 5. Maintenance

Due to severe periodontitis, #23 is already extruded and mobile. Since moderate to severe bony defect was predicted, staged approach to regenerate bony defect planed.

5 weeks after extraction, soft tissue around extraction socket was closed up

Full thickness flap was raised and vertical bony defect was noted. The defect was grafted with FDBA (ICB cortical)

Defect was proteced by CTI membrane (E-type) and covered by resorbable collagen membrane.

Flaps were closed and sutured by 5-0 Dafilon

7 month after GBR. No exposure of CTi membrane was observed. Good soft tissue healing.

CT scan after GBR shows significant amount of alveolar bone regeneration.

Both horizontal and vertical bone regeneration was noticed clinically.

Neobiotech IS II active implant (size of 4.0x10) was placed and primary stability was achieved (30N/cm)

Good healing after implant placement was noticed.

After 3months of healing, uncovering was performed.

Final restoration was fabricated and cemented. Good pink and white esthetics.

Pre operative and post operative pictures. Reasonable esthetics was achieved.