Page 60 - DP Vol 21 No1_Neat

IMPLANTOLOGY SECTION

IMPLANT SITE –

HARD AND SOFT TISSUE AUGMENTATION

Tarun Kumar and S. Rekha Suresh

THE SITUATION
Young adult, 21-year-old with a history of trauma with loss of
maxillary anterior teeth 2 months ago, presents with severe
hard tissue (<4mm) and soft tissue deficiency and desires a
fixed implant based aesthetic prosthesis.

THE APPROACH
Two implants were placed in the anterior maxilla along with
simultaneous hard tissue augmentation using the sausage
technique (1:1 ratio of autogenous bone and Geistlich Bio-
Oss®, covered by Geistlich Bio-Gide® stretched over the graft
material and stabilized by membrane tacks). Four months
post operatively, good peri-implant bone augmentation
was observed and a temporary prosthesis was given. Soft
tissue augmentation using connective tissue graft was done Fig 1: Pre-operative deficient ridge
to compensate for the deficient soft tissue bulk and esthetic
emergence profile. Final prosthesis was delivered 6 months
postoperatively.

THE OUTCOME
Five-year post-operative results demonstrate stable crestal
bone levels, good peri-implant tissue health and overall an
esthetically pleasing result.

KEYS TO SUCCESS
• Flap management
• Bone regeneration with 1:1 autograft and Xenograft
• Stabilization and stretching effect of the membrane
• Soft tissue augmentation to achieve soft tissue bulk and
good emergence profile
• Peri-implant supportive therapy

CLINICAL CHALLENGES Fig 2: Implant osteotomy
• Atrophied alveolar ridge for implant placement
• Collapse of soft tissue
• Risk of high patient morbidity due to a need of block
grafting
• Patient’s desire for an aesthetic prosthesis

CONCLUSION
Implant placement with simultaneous ridge augmentation
using 1:1 autograft and Xenograft (Geistlich Bio-Oss®)
allowed for significant bone gain.
At 4 months, soft tissue augmentation to correct the soft
tissue deficiency resulted in good emergence profile and
stable aesthetic results. n Fig 3: Implant placement using surgical stent

60 Dental Practice I January-February 2025 I Vol 21 No 1