3D Rectangular bone augmentation and simultaneous implant placement

3D Rectangular bone augmentation and simultaneous implant placement

Introduction:
- Lack of 3D bone is a big challenge to restore and place Implant in right position for prosthetics. This case is generally carried out through 2 stages: Bone grafting and then Implant placement

- The new method can help Implant placement and bone graft simultaneously. It uses Implant to stabilize the bone and use bone to stabilize the Implant. In reality, this is a technique challenge but there is an advantage that helps shortening the treatment time while still achieving good results.

Method and Patient
- Three patients with 3D bone defects caused by periodontal disease
   + 1st stage: Need extraction, two months later to heal soft tissue and decrease the infection.
   + 2nd stage: 3D bone augmentation and simultaneous Implant placement.

- Cut a rectangular bone block at the symphysis or retromolar with Piezotome machine

- Prepare Implant bed on this rectangular bone block so that Implant bed is slightly smaller than the Implant's diameter in order to create a friction on the bone when placing Implant and help Implant stabilize grafted bone block (use taper Implant whose top part of Implant still stays in the cortical bone of rectangular bone block).

- Use tapper Implant with self cutting or progressive thread to help Implant apex anchored in the alveolar crest to create an initial stability: It's recommended using Implant 11-14mm in length.

- When Implant is inserted into the alveolar Implant bed, cervical Implant will bring rectangular bone block forward to the Implant apex.

- Until this bone block contacts with the mesial and distal remaining alveolar bone, this contact will create a stop point helping Implant more stable. In this case, bone will stabilize the Implant and Implant will stabilize the bone.

- The remaining space is grafted with particular autogenous bone and biological material (4Bone) and then covered with resorbable membrane and suture.

 

Technical requirements:
- Enough residual bone to provide primary stability for Implant
- Close Primary tension-free flap.

 

CLINICAL CASE

Case 1:
Surgeon: Vo Van Nhan DDS, MDS
Patient: N. T. T
Sex: Male
Patient presented with acute infection at the anterior teeth, needing extraction and 3D rectangular bone augmentation and simultaneous Implant placement

3d-rectangular-bone-augmentation-and-simultaneous-implant-placement

 

 

3d-rectangular-bone-augmentation-and-simultaneous-implant-placement

  * The effecitveness of treatment depends on each person's particular health condition 

 

Case 2
Surgeon: Vo Van Nhan DDS, MDS
Patient: L.D
Sex: Male
Patient had chronic periodontal disease at the anterior teeth, needing extraction and 3D rectangular bone augmentation and simultaneous Implant placement.

3d-rectangular-bone-augmentation-and-simultaneous-implant-placement

  

3d-rectangular-bone-augmentation-and-simultaneous-implant-placement

 * The effecitveness of treatment depends on each person's particular health condition 

 

Result
- After 4-5 months, the flap was opened showing good result, healing and integrated Implant.
- 2 weeks later, final restoration was delivered.
Follow up time: 14,5 months (11-21 months)
- Patient reported being satisfied with the contour and functional rehabilitation.

 

Conclusion
- The 3D bone augmentation and simultaneous Implant placement technique has preliminary good result.
- Implant's integration as well as aesthetic and functional elements of prosthetics are all good. Long term effects need further observation.

 

Nhan Tam Dental Clinic

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