Page 21 - GP Fall Final 2017

two weeks following the AOO procedure, retention with a Hawley appliance was #23 was grafted for a second time. Fig-
®

a focal osteopenia is developing through- used to initiate the retention phase of the ure 13 clearly displays the body’s ability future resorption. Near primary closure is attained to
The graft is permitted to mature for an additional 5
out the bone activated at the surgical site. case. An Essix retainer was recommended to regenerate new bone to fill extraction protect the graft, fig. 17. Fixed provisionalization at
months. The next step in the reconstruction process is
Once the Regionally Activated Phenomena for long-term retention. socket voids with the same rate and effi-
to insert a single dental implant fixture. The selection
has occurred, accelerated osteogenic turn- ciency that existing vital labial plates can this stage is completed by
of the implant fixture is limited by the width of the
over can be expected. During any treatment Immediate and in treatment provisional- be expanded and remodeled. For this rea- the restorative dentist;
extraction/regeneration procedure. Tooth #23 is Immediate and in treatment provisionalization is edentulous space between the mesial and distal figs. 10 and 18. The
whose intent is to stimulate a rapid osteo-
ization was predominantly completed by son, a second regeneration procedure was
extracted resulting in the development of a tapering predominantly completed by first using the natural proximal tooth surfaces. Mandibular anterior teeth are provisional restoration
genic process, patients should be strongly first using the natural enamel crown then needed to complete an acceptable ridge
enamel crown then applying prosthetic acrylic pontics, always considerably narrower in the mesial/distal finishes supra-gingival for
applying prosthetic acrylic pontics (Figures augmentation (Figure 14).
advised that use of any non-steroidal an-
figs. 9 and 10. 9,10) for short periods of time during care. dimension than they are from labial/lingual. Care ease of maintenance,
ti-inflammatory drugs (NSAIDs) will rap-
should be exercised not to select a fixture that will
idly and irreversibly shut down the desired Removable temporization may be neces- The graft was permitted to mature for an intending to reduce the risk
crowd the site causing ischemia and necrosis of the
biologic process. sary in some cases. additional five months. The next step in the of chronic inflammation.
interproximal regenerated bone. For that reason, a
reconstruction process was to insert a single Controlling inflammation
single stage dental implant fixture (3.0mm X 13mm) is
Orthodontic Treatment Within six weeks following the regenera- dental implant fixture. The selection of the Fig. 18 improves healing and
selected. Single stage fixtures have both advantages
Orthodontics was initiated with the place- tion/activation procedures, positive results implant fixture is limited by the width of the enhances integration.
and disadvantages to their use.
ment of Dentsply GAC In-Ovation R and were apparent (Figures 11,12). Space de- edentulous space between the mesial and
The abutment is milled with the implant fixture
•
Fig. 5 Fig. 6 C .002 brackets with a -6° lingual crown velopment and ridge regeneration are not- distal proximal tooth surfaces. Mandibular Once graft maturation and integration is attained, the
as a single metal body. There are no joints to
1-3 walled ridge defect, fig. 5. Corticotomies are torque for the mandibular incisors. Brack- ed in the aforementioned digital images. anterior teeth are always considerably nar- mucogingival deficiencies are addressed. Arch

open, no screws to loosen or break, and the
Fig. 9 Fig. 10
completed, fig. 6, preceding the introduction of ets were placed on the entire mandibular However, the orthodontic forces expand rower in the mesial/distal dimension than expansion inherently stresses the periodontium. When
risk of implant connection fracture/failure is
For short periods of time during care, removable
composite graft materials fig. 7. Primary closure with arch as anchorage to prevent overexpansion only the ridge plates housing the adjacent they are from labial/lingual. Care should expansion occurs adjacent to a non-expanding or

of the mandibular anterior sextant, while teeth. There is no expansion at the eden- eliminated. Connection fracture (flowering or atrophying edentulous space, mucogingival recession
temporization may be necessary in some cases.
future resorption. Near primary closure is attained to
The graft is permitted to mature for an additional 5
continuing to retain the buccal occlusal re- tulous space. The edentulous space lacks be exercised not to select a fixture that will protect the graft, fig. 17. Fixed provisionalization at
tuliping) is a common problem with thinly
can amplify. The loss of any tooth can have an impact
months. The next step in the reconstruction process is

crowd the site causing ischemia and necrosis
on the attached tissues of the
milled connector walls. Some implant
to insert a single dental implant fixture. The selection

lationship. The patient declined maxillary the applied labial force to a vital cortical of the interproximal regenerated bone. For this stage is completed by

adjacent teeth. (ie. The loss
manufacturing designs are at a higher risk for
of the implant fixture is limited by the width of the
arch orthodontic care. plate. Some particulate graft compres- that reason, a single stage dental implant fix- the restorative dentist;

sion and resorption can be expected at the
of a first molar will often
this problem.
extraction/regeneration procedure. Tooth #23 is Immediate and in treatment provisionalization figs. 10 and 18. The
edentulous space between the mesial and distal is
Immediate and in treatment provisionalization is
extraction/regeneration procedure. Tooth #23 is
ture (3.0mm X 13mm) was selected. Single
A passive .016 stainless steel archwire was edentulous site.
result in buccal plate atrophy
Although the abutment can be slightly adjusted
•
proximal tooth surfaces. Mandibular anterior teeth are
extracted resulting in the development of a tapering predominantly completed by first using the natural provisional restoration
extracted resulting in the development of a tapering
stage fixtures have both advantages and dis-
predominantly completed by first using the natural
applied while the bone graft and corticoto-
in the mouth, single stage implant fixtures are
with corresponding buccal
always considerably narrower in the mesial/distal
enamel crown then applying prosthetic acrylic pontics,
enamel crown then applying prosthetic acrylic pontics,
mies were completed. The enamel crown In four months and one week, the ortho- advantages to their use. finishes supra-gingival for
best fitted and finished with a thin, tapering
recession on the second
dimension than they are from labial/lingual. Care
figs. 9 and 10.
was affixed to the archwire (Figure 9), as an dontic care was complete. The space was • The abutment is milled with the implant ease of maintenance,
figs. 9 and 10.
bicuspid.) Surgical
margin. For aesthetic purposes, ridge laps are
should be exercised not to select a fixture that will
Fig. 7 Fig. 8 aesthetic transitional solution. Following a achieved at #23. Doses of NSAIDs were fixture as a single metal body. There are intending to reduce the risk
instrumentation, with flap
crowd the site causing ischemia and necrosis of the to conform to a thinner
often required
ePTFE suture is important to prevent loss of the graft slight interproximal reduction of the man- initiated to arrest the osteogenic process, no joints to open, no screws to loosen of chronic inflammation.

mesial/distal dimension while accommodating
elevation, will also contribute
or exposure of the thin, fragile labial and lingual plates Fig. 11 Fig. 12 interproximal regenerated bone. For that reason, a Controlling inflammation
or break, and the risk of implant con-
dibular incisors, a .014 Sentinol archwire enhancing the long-term retention of the
a much wider labial/lingual space to fill.
to resorption and recession. Fig. 19
of bone, fig. 8. During the first two weeks following Within 6 weeks following the regeneration/activation single stage dental implant fixture (3.0mm X 13mm) is Fig. 18 improves healing and
nection fracture/failure is eliminated.
was placed for three weeks. At that point, a case. Re-evaluation of the case revealed
A single osteotomy is slowly completed with a series of
the AOO® procedure, a focal osteopenia is developing procedures positive results are apparent, fig. 11 and selected. Single stage fixtures have both advantages enhances integration. In discussing this case, the periodontium of the
Connection fracture (flowering or tulip-
.020 X .020 archwire with active coil spring two concerns. There was an expected ridge
well

throughout the bone activated at the surgical site. fig. 12. Space development and ridge regeneration and disadvantages to their use. irrigated pilot and surgical drills. Care is taken to treatment site shows stresses from rehabilitation care.
ing) is a common problem with thinly
was introduced for 6 weeks followed by 7 deficit at the edentulous site of #23 and

Once graft maturation and integration is attained, the
Once the Regionally Activated Phenomena has are noted in the fore mentioned digital images. • The abutment is milled with the implant fixture retain an adequate margin The thin periodontium responds with gingival recession
milled connector walls. Some implant
the attached gingival is stressing through-
Fig. 5 Fig. 6
Fig. 5 Fig.
weeks of .017 X .025 TMA archwire to co- 6
mucogingival deficiencies are addressed. Arch
manufacturing designs are at a higher
occurred, accelerated osteogenic turnover can be 1-3 walled as a single metal body. There are no joints to of surrounding bone on the labial aspect of the adjacent teeth. Left un-
However, the Orthodontic forces expand only the ridge

ordinate and detail the occlusion. A three out the labial aspect of the expanded ante-
ridge defect, fig. 5. Corticotomies are
1-3 walled ridge defect, fig. 5. Corticotomies are

expansion inherently stresses the periodontium. When
open, no screws to loosen or break, and the
expected. During any treatment whose intent is to
Immediate and in treatment provisionalization
extraction/regeneration procedure. Tooth #23 is completed, fig. 6, preceding the introduction of Fig. 9 Fig. 10 (approximately 2mm of attended, this recession can be expected to progress
plates housing the adjacent teeth. There is no is
risk for this problem.
extraction/regeneration procedure. Tooth #23 is
week orthodontic appointment schedule rior sextant. Six weeks following removal
Immediate and in treatment provisionalization is
Fig. 9 Fig. 10
completed, fig. 6, preceding the introduction of
expansion occurs adjacent to a non-expanding or loss. Soft tissue grafting is
risk of implant connection fracture/failure is
stimulate a rapid osteogenic process, patients should
expansion at the edentulous space. The edentulous
extracted resulting in the development of a tapering composite graft materials fig. 7. Primary closure with For short periods • Although the abutment can be slight- healthy bone). If the causing further tissue
predominantly completed by first using the natural
predominantly completed by first using the natural
extracted resulting in the development of a tapering
For short periods of time during care, removable
composite graft materials fig. 7. Primary closure with
was maintained during active care. Fixed of the orthodontic appliances, the ridge at of time during care, removable
atrophying edentulous space, mucogingival recession lost attached keratinized soft
eliminated. Connection fracture (flowering or
be strongly advised that use of any Non-Steroidal enamel crown then applying prosthetic acrylic pontics, temporization may be necessary in some cases. retained bone mass is less completed to replace the
space lacks the applied labial force to a vital cortical
ly adjusted in the mouth, single stage
enamel crown then applying prosthetic acrylic pontics, temporization may be necessary in some cases.
can amplify. The loss of any tooth can have an impact
Anti-Inflammatory Drugs (Nsaids) will rapidly and figs. 9 and 10. tuliping) is a common problem with thinly than 2mm, ischemia and tissues. A labial
plate. Some particulate graft compression and
figs. 9 and 10.
on the attached tissues of the
irreversibly shut down the desired biologic process. resorption can be expected at the edentulous site. milled connector walls. Some implant necrosis can be expected envelope is raised
adjacent teeth. (ie. The loss
manufacturing designs are at a higher risk for due to a constriction of followed by the coronal
of a first molar will often
ORTHODONTIC TREATMENT In 4 months and 1 week the Orthodontic care is this problem. normal blood flow through- repositioning of the
Fig. 15 out the walls of the bone.
complete. The space is achieved at #23. Doses of • Although the abutment can be slightly adjusted result in buccal plate atrophy remaining attached
with corresponding buccal
To properly develop this
Orthodontics initiated with the placement of Dentsply Nsaids are initiated to arrest the osteogenic process, in the mouth, single stage implant fixtures are site, a minimum of 7mm is tissues. Decortication is
needed to be recaptured
recession on the second
GAC In-Ovation R and C .002 brackets with a -6° enhancing the long-term retention of the case. Re- best fitted and finished with a thin, tapering between #22 and #24: 2mm also completed to

mesial + 2mm distal + 3mm for the osteotomy and
lingual crown torque for the mandibular incisors. evaluation of the case reveals two concerns. There is margin. For aesthetic purposes, ridge laps are bicuspid.) Surgical immediately enhance
Fig. 7 Fig. 8
Fig. 5 Fig. 6 Fig. 7 Fig. 8 often required to conform to a thinner instrumentation, with flap the blood supply while
Fig. 5 Fig. 6
Brackets are placed on the entire mandibular arch as
fixture. Many authors recommend 3mm of septal bone
an expected ridge deficit at the edentulous #23. And,
ePTFE suture is important to prevent loss of the graft
1-3 walled ridge defect, fig. 5. Corticotomies are ePTFE suture is important to prevent mesial/distal dimension while accommodating elevation, will also contribute stimulating biological
loss of the graft
1-3 walled ridge defect, fig. 5. Corticotomies are

between the implant fixture and the adjacent teeth.
the attached gingiva is stressing throughout the labial
anchorage preventing over expansion of the
or exposure of the thin, fragile labial and lingual plates
completed, fig. 6, preceding the introduction of
Fig. 9 Fig. 10
Fig. 9 Fig. 10
completed, fig. 6, preceding the introduction of or exposure of the thin, fragile labial and lingual plates Fig. 11 to resorption and recession. Fig. 19
Fig. 11 Fig. 12
Figure 11. Figure 12. Fig. 12
Figure 9.
Figure 10.
Although biologically
a much wider labial/lingual space to fill. optimal, a 9mm edentulous space
Fig. 20 repair. A harvested
mandibular anterior sextant, while continuing to retain
aspect of the expanded anterior sextant. Six weeks
composite graft materials fig. 7. Primary closure with of bone, fig. 8. During the first two weeks following Within 6 weeks following the regeneration/activation In discussing this case, the periodontium of the palatal donor graft is
For short periods of time during care, removable
Within 6 weeks following the regeneration/activation
composite graft materials fig. 7. Primary closure with of bone, fig. 8. During the first two weeks following
For short periods of time during care, removable
A single osteotomy is slowly completed with a series of
will restore many mandibular anterior cases with a
the buccal occlusal relationship. The patient declined
following removal of the Orthodontic appliances, the
temporization may be necessary in some cases.
the AOO® procedure, a focal osteopenia is developing .
temporization may be necessary in some cases
procedures positive results are apparent, fig. 11 and
well irrigated pilot and surgical drills. Care is taken to
non-aesthetic, oversized crown restoration.
maxillary arch orthodontic care. the AOO® procedure, a focal osteopenia is developing procedures positive results are apparent, fig. 11 and treatment site shows stresses from rehabilitation care. positioned and secured
ridge at #23 is grafted for a second time. Figure 13
throughout the bone activated at the surgical site.
fig. 12. Space development and ridge regeneration
retain an adequate margin
througho ut the bone activated at the surgical site. fig. 12. Space development and ridge regeneration The thin periodontium responds with gingival recession across the expanse of
Once the Regionally Activated Phenomena has
are noted in the fore mentioned digital images.
of surrounding bone
A passive .016 stainless steel archwire is applied while Once the Regionally Activated Phenomena has are noted in the fore mentioned digital images. on the labial aspect of the adjacent teeth. Left un- the labial plate (#25-
occurred, accelerated osteogenic turnover can be
However, the Orthodontic forces expand only the ridge
(approximately 2mm of
the bone graft and corticotomies are completed. The occurred, accelerated osteogenic turnover can be However, the Orthodontic forces expand only the ridge attended, this recession can be expected to progress 21), fig. 20. Vitality is
expected. During any treatment whose intent is to
plates housing the adjacent teeth. There is no
healthy bone). If the
enamel crown is affixed to the archwire, fig. 9, as an expected. During any treatment whose intent is to plates housing the adjacent teeth. There is no causing further tissue loss. Soft tissue grafting is further introduced by
stimulate a rapid osteogenic process, patients should
expansion at the edentulous space. The edentulous
retained bone mass is less
aesthetic transitional solution. Following a slight stimulate a rapid osteogenic process, patients should expansion at the edentulous space. The edentulous completed to replace the lost attached keratinized soft securely immobilizing
be strongly advised that use of any Non-Steroidal
space lacks the applied labial force to a vital cortical
than 2mm, ischemia and
interproximal reduction of the mandibular incisors, a be strongly advised that use of any Non-Steroidal space lacks the applied labial force to a vital cortical tissues. A labial the labial flap and the
Anti-Inflammatory Drugs (Nsaids) will rapidly and
plate. Some particulate graft compression and
necrosis can be expected
.014 Sentinol archwire is placed for three weeks. At Anti-Inflammatory Drugs (Nsaids) will rapidly and plate. Some particulate graft compression and envelope is raised donor tissue, fig. 21.

irreversibly shut down the desired biologic process.
resorption can be expected at the edentulous site.
due to a constriction of
Fig. 7 Fig. 8
Fig. 7 Fig. 8 irreversibly shut down the desired biologic process. resorption can be expected at the edentulous site. followed by the coronal With appropriate tech-
that point, a .020 X .020 archwire with active coil

repositioning of the
ePTFE suture is important to prevent loss of the graft

normal blood flow through-
spring is introduced for 6 weeks followed by 7 weeks of
ePTFE suture is important to prevent loss of the graft Fig. 13 Fig. 14 Figure 15. Figure 16. Fig. 21 nique, a fibrin clot
Fig. 16 Fig. 17

Figure 14.
Figure 13.

ORTHODONTIC TREATMENT
In 4 months and 1 week the Orthodontic care is
or exposure of the thin, fragile labial and lingual plates
Fig. 15 out the walls of the bone.
or exposure of the thin, fragile labial and lingual plates ORTHODONTIC TREATMENT In 4 months and 1 week the Orthodontic care is is quickly established
.017 X .025 TMA archwire to coordinate and detail the
Fig. 11 Fig. 12
Fig. 11 Fig. 12
remaining attached permitting the development of a
While preparing the osteotomy, autogenous bone is
clearly displays the body’s inability to regenerate new
complete. The space is achieved at #23. Doses of
www.nysagd.org l Fall 2017 l GP 18
tissues. Decortication is
To properly develop this site, a minimum of 7mm is
of bone, fig. 8. During the first two weeks following
Within 6 weeks following the regeneration/activation
of bone, fig. 8. During the first two weeks followin Within 6 weeks following the regeneration/activation complete. The space is achieved at #23. Doses of renewed plexus of collateral revascularization. A
occlusion. A three week orthodontic appointment g
harvested during the process. This bone is used to
bone to fill extraction socket voids with the same rate
Orthodontics initiated with the placement of Dentsply
Nsaids are initiated to arrest the osteogenic process,
needed to be recaptured between #22 and #24: 2mm
also completed to
the AOO® procedure, a focal osteopenia is developing
schedule is maintained during active care. Fixed ping
procedures positive results are apparent, fig. 11 and
the AOO® procedure, a focal osteopenia is develo Orthodontics initiated with the placement of Dentsply Nsaids are initiated to arrest the osteogenic process, renewed blood supply, enhanced by immobilization, is
procedures positive results are apparent, fig. 11 and
enhance the ridge regeneration on the labial aspect of
and efficiency that existing vital labial plates can be
GAC In-Ovation R and C .002 brackets with a -6°
enhancing the long-term retention of the case. Re-
immediately enhance
mesial + 2mm distal + 3mm for the osteotomy and
throughout the bone activated at the surgical site.
throughout the bone activated at the surgical site. GAC In-Ovation R and C .002 brackets with a -6° enhancing the long-term retention of the case. Re- the key to successful graft acceptance.
retention with a Hawley appliance is used to initiate
fig. 12. Space development and ridge regeneration
fig. 12. Space development and ridge regeneration
the dental implant fixture, fig 16. The labial plate of
expanded and remodeled. For this reason, a second
lingual crown torque for the mandibular incisors.
evaluation of the case reveals two concerns. There is
the retention phase of the case. An Essix retainer is lingual crown torque for the mandibular incisors.
fixture. Many authors recommend 3mm of septal bone
Once the Regionally Activated Phenomena has
Once the Regionally Activated Phenomena has Brackets are placed on the entire mandibular arch as evaluation of the case reveals two concerns. There is the blood supply while
are noted in the fore mentioned digital images.
are noted in the fore mentioned digital images.
regeneration procedure is needed to complete an
any dental implant case is often the most at risk for
an expected ridge deficit at the edentulous #23. And,
between the implant fixture and the adjacent teeth.
recommended for long term retention.
occurred, accelerated osteogenic turnover can be
However, the Orthodontic forces expand only the ridge
occurred, accelerated osteogenic turnover can be Brackets are placed on the entire mandibular arch as an expected ridge deficit at the edentulous #23. And, stimulating biological
acceptable ridge augmentation, fig. 14. only the ridge
However, the Orthodontic forces expand
anchorage preventing over expansion of the
the attached gingiva is stressing throughout the labial
Although biologically optimal, a 9mm edentulous space
expected. During any treatment whose intent is to
plates housing the adjacent teeth. There is no
expected. During any treatment whose intent is to anchorage preventing over expansion of the the attached gingiva is stressing throughout the labial Fig. 20 repair. A harvested
plates housing the adjacent teeth. There is no
mandibular anterior sextant, while continuing to retain
aspect of the expanded anterior sextant. Six weeks
will restore many mandibular anterior cases with a
stimulate a rapid osteogenic process, patients should
stimulate a rapid osteogenic process, patients should mandibular anterior sextant, while continuing to retain aspect of the expanded anterior sextant. Six weeks palatal donor graft is
expansion at the edentulous space. The edentulous
expansion at the edentulous space. The edentulous
the buccal occlusal relationship. The patient declined
following removal of the Orthodontic appliances, the
non-aesthetic, oversized crown restoration.
space lacks the applied labial force to a vital cortical
be strongly advised that use of any Non-Steroidal
be strongly advised that use of any Non-Steroidal the buccal occlusal relationship. The patient declined following removal of the Orthodontic appliances, the positioned and secured
space lacks the applied labial force to a vital cortical
maxillary arch orthodontic care.
ridge at #23 is grafted for a second time. Figure 13
Anti-Inflammatory Drugs (Nsaids) will rapidly and
Anti-Inflammatory Drugs (Nsaids) will rapidly and maxillary arch orthodontic care. ridge at #23 is grafted for a second time. Figure 13 across the expanse of
plate. Some particulate graft compression and
plate. Some particulate graft compression and

irreversibly shut down the desired biologic process.
resorption can be expected at the edentulous site.
irreversibly shut down the desired biologic process. A passive .016 stainless steel archwire is applied while the labial plate (#25-
resorption can be expected at the edentulous site.

A passive .016 stainless steel archwire is applied while 21), fig. 20. Vitality is

the bone graft and corticotomies are completed. The
ORTHODONTIC TREATMENT
ORTHODONTIC TREATMENT the bone graft and corticotomies are completed. The further introduced by
In 4 months and 1 week the Orthodontic care is
In 4 months and 1 week the Orthodontic care is
enamel crown is affixed to the archwire, fig. 9, as an
complete. The space is achieved at #23. Doses of
enamel crown is affixed to the archwire, fig. 9, as an securely immobilizing
complete. The space is achieved at #23. Doses of
aesthetic transitional solution. Following a slight
Nsaids are initiated to arrest the osteogenic process,
Orthodontics initiated with the placement of Dentsply
Nsaids are initiated to arrest the osteogenic process,
Orthodontics initiated with the placement of Dentsply aesthetic transitional solution. Following a slight the labial flap and the
interproximal reduction of the mandibular incisors, a
GAC In-Ovation R and C .002 brackets with a -6°
enhancing the long-term retention of the case. Re-
GAC In-Ovation R and C .002 brackets with a -6° interproximal reduction of the mandibular incisors, a donor tissue, fig. 21.
enhancing the long-term retention of the case. Re-
.014 Sentinol archwire is placed for three weeks. At
With appropriate tech-
lingual crown torque for the mandibular incisors.
evaluation of the case reveals two concerns. There is
lingual crown torque for the mandibular incisors. .014 Sentinol archwire is placed for three weeks. At
evaluation of the case reveals two concerns. There is
that point, a .020 X .020 archwire with active coil
an expected ridge deficit at the edentulous #23. And, Fig. 16 Fig. 17
Brackets are placed on the entire mandibular arch as

Brackets are placed on the entire mandibular arch as that point, a .020 X .020 archwire with active coil Fig. 13 Fig. 14 Fig. 21 nique, a fibrin clot
an expected ridge deficit at the edentulous #23. And,

spring is introduced for 6 weeks followed by 7 weeks of
is quickly established permitting the development of a
anchorage preventing over expansion of the
the attached gingiva is stressing throughout the labial Fig. 13 Fig. 14
anchorage preventing over expansion of the spring is introduced for 6 weeks followed by 7 weeks of While preparing the osteotomy, autogenous bone is renewed plexus of collateral revascularization. A
the attached gingiva is stressing throughout the labial
.017 X .025 TMA archwire to coordinate and detail the
clearly displays the body’s inability to regenerate new
mandibular anterior sextant, while continuing to retain .017 X .025 TMA archwire to coordinate and detail the
harvested during the process. This bone is used to
aspect of the expanded anterior sextant. Six weeks
mandibular anterior sextant, while continuing to retain occlusion. A three week orthodontic appointment clearly displays the body’s inability to regenerate new renewed blood supply, enhanced by immobilization, is
aspect of the expanded anterior sextant. Six weeks
bone to fill extraction socket voids with the same rate
the buccal occlusal relationship. The patient declined occlusion. A three week orthodontic appointment
enhance the ridge regeneration on the labial aspect of
following removal of the Orthodontic appliances, the
the buccal occlusal relationship. The patient declined schedule is maintained during active care. Fixed bone to fill extraction socket voids with the same rate the key to successful graft acceptance.
following removal of the Orthodontic appliances, the
schedule is maintained during active care. Fixed
and efficiency that existing vital labial plates can be
maxillary arch orthodontic care.
ridge at #23 is grafted for a second time. Figure 13 and efficiency that existing vital labial plates can be
maxillary arch orthodontic care. retention with a Hawley appliance is used to initiate the dental implant fixture, fig 16. The labial plate of
ridge at #23 is grafted for a second time. Figure 13
expanded and remodeled. For this reason, a second
any dental implant case is often the most at risk for
retention with a Hawley appliance is used to initiate expanded and remodeled. For this reason, a second
the retention phase of the case. An Essix retainer is
regeneration procedure is needed to complete an
A passive .016 stainless steel archwire is applied while
A passive .016 stainless steel archwire is applied while the retention phase of the case. An Essix retainer is regeneration procedure is needed to complete an
recommended for long term retention.
acceptable ridge augmentation, fig. 14.
recommended for long term retention.
the bone graft and corticotomies are completed. The
the bone graft and corticotomies are completed. The acceptable ridge augmentation, fig. 14.

enamel crown is affixed to the archwire, fig. 9, as an
enamel crown is affixed to the archwire, fig. 9, as an
aesthetic transitional solution. Following a slight
aesthetic transitional solution. Following a slight
interproximal reduction of the mandibular incisors, a
interproximal reduction of the mandibular incisors, a
.014 Sentinol archwire is placed for three weeks. At
.014 Sentinol archwire is placed for three weeks. At
that point, a .020 X .020 archwire with active coil
that point, a .020 X .020 archwire with active coil

spring is introduced for 6 weeks followed by 7 weeks of
spring is introduced for 6 weeks followed by 7 weeks of Fig. 13 Fig. 14
Fig. 13 Fig. 14
.017 X .025 TMA archwire to coordinate and detail the
clearly displays the body’s inability to regenerate new
.017 X .025 TMA archwire to coordinate and detail the clearly displays the body’s inability to regenerate new
occlusion. A three week orthodontic appointment
bone to fill extraction socket voids with the same rate
occlusion. A three week orthodontic appointment bone to fill extraction socket voids with the same rate
schedule is maintained during active care. Fixed
and efficiency that existing vital labial plates can be
schedule is maintained during active care. Fixed and efficiency that existing vital labial plates can be
retention with a Hawley appliance is used to initiate
expanded and remodeled. For this reason, a second
retention with a Hawley appliance is used to initiate expanded and remodeled. For this reason, a second
the retention phase of the case. An Essix retainer is
regeneration procedure is needed to complete an
the retention phase of the case. An Essix retainer is regeneration procedure is needed to complete an
recommended for long term retention.
acceptable ridge augmentation, fig. 14.
recommended for long term retention. acceptable ridge augmentation, fig. 14.