Horizontal Bone Augmentation in the Anterior Esthetic Area of the Maxilla Using a Flap Design Adapted from Mucogingival Surgery in Association with PLA Membrane and β-TCP

The International Journal of Periodontics & Restorative Dentistry
Luigi CanulloLorenzo Mordini

Abstract

Systematic reviews showed possible esthetic complications with the use of traditional flap designs after guided bone regeneration (GBR) procedures in the esthetic zone and the aim of this case series was to analyze hard and soft tissue changes over 18 months after these procedures. Healthy subjects requiring tooth extraction and single-implant placement in the anterior maxilla were enrolled in the study. Three months after tooth extraction and ridge preservation, a prosthetic-driven implant was placed. The horizontal bone deficiency was treated with a resorbable bone graft substitute (beta tricalcium phosphate [β-TCP]) and a bioresorbable polylactic acid (PLA) membrane. Primary closure was obtained by a novel coronally advanced flap adapted from mucogingival techniques. Final metal-free implant restorations were delivered 4 months after placement. Clinical measurements, pictures, and radiographs were acquired after delivery of the final restoration (T1) and at the 18-month follow-up (T2). Digital impressions were taken at the time of tooth extraction (T-1) and implant insertion (baseline; T0) and at T2. Marginal bone level changes were assessed by radiographic analysis, while soft tissue changes were evaluated with ExoCad softw...Continue Reading

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