Vertical bone augmentation with Tent screw and CTi-mem

Pre-operative Observation

#24 and 25 had advanced periodontal disease with severe vertical bone resorption.

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Clinical buccal view after extraction of #24 and #25 showed severe vertical defect.

A periapical radiograph showed severe bone defect. However, proximal bone of both #24 and #25 were intact so it was possible to build up bone up to the line.

A clinical buccal view showed severe vertical bone defect without buccal and lingual bony walls. A Tent screw was inserted instead of an implant to create vertical space.

An allograft (RegenOss, FDBA) was applied to the defect up to a height of Tent screw.

Two titanium meshes (CTi-mem, Neobiotech) were fixed on the Tent screw.

A collagen membrane (CollaTape) was placed over the titanium meshes for minimizing mesh exposures.

Mattress key sutures were made to decrease exposures.

The soft tissue has healed without membrane exposures.

Panoramic view showed a vertical augmentation with a Tent screw.

An incision was made to expose the titanium mesh at 6 months of the GBR procedure.

The CTi-mems were easily removed.

The large vertical defect was fully regenerated with new dense bone. It might be due to vertical space maintained with a Tent screw and titanium meshes.

Periapical radiograph shows the amount of vertical augmentation.

An occlusal view shows good buccal bone regeneration.

Preop.

6 months postop. Approximately 7mm of vertical new bone was gained.

Enough buccolingual bone width was regenerated.

2 internal type of CMI IS ll active implants were placed in the regenerated bone.

2 implants were placed with 40Ncm of initial stability in the D3 bone density.

2 healing abutments were connected and the wound margins were closed with sutures.

Panoramic view after implant placement.

Periapical view after finishing the prosthesis.