Case Studies

Case Presentations which quickly get to the point. They show the problem and then get right into how the case was treated. Critical principles are outlined. You can see what materials were used and how the case turned out.

Management of a “blow-out” defect on a maxillary canine

By Dr. Frédéric Chapon

A “Blow-Out defect” is the sudden disappearance of supporting bone about a tooth. In such situations, case management can be complex and demanding. In this case the tooth involved was a maxillary canine. It took several months of therapy to regenerate sufficient bone volume in the region to support an implant.

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A maxillary anterior transition made possible by custom bone block augmentation

By Dr. Jan Spieckermann

This presentation shows a maxillary anterior region which had lost bone support following the removal of the four incisors. To overcome the problem two custom bone blocks were designed and milled from human cadaver head of femur bone. These were placed and secured in the affected region. After a suitable healing time it was possible to place implants and to complete a successful rehabilitation.

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Bisphosphonate related osteonecrosis of the mandible following dental implant placement

By Dr. Gary Warburton

This case presents the uncommon occurrence of Bisphosphonate Related Osteo-Necrosis of the Jaw (BRONJ) following the placement of implants in a patient who had been taking oral bisphosphonates (Alendronate - Fosamax) for 5 years. Resection of the affected part of the mandible was required with an iliac crest graft then being placed to restore mandibular continuity. Eight months later, five implants were placed into the region and this allowed the region to be restored with a fixed hybrid reconstruction.

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Retaining the Supra-Crestal Architecture

By Dr Paul Sipos

A case where a maxillary central incisor was hopeless. It was removed and the the crown and a small part of the root structure was bonded back into place with the hope and expectation that good socket regeneration would occur. However although the gingival complex was retained well, a residual bone defect remained. To compensate, an apical approach to the region was made. This did not disturb the crestal soft tissue architecture. It was possible to debride the region, to place an implant (through a minimal crestal opening) and then to augment with Bio-Oss and Bio Gide. This allowed a very satisfactory final restorative result to be developed.

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Narrow ridge management with ultrasonics and osteotomes

By Dr. Peter Hunt

A narrow maxillary posterior ridge remained several years following the removal of the second premolar and the first molar. The edentulous ridge was exposed and confirmed to be very narrow. Ultrasonics were used to initiate bone channels. These were expanded steadily with osteotome action, enough to allow implants to be placed. The more distal implant also had an internal sinus lift. After the placement of the implants, the ridge was further expanded by external augmentation and a membrane. The pre-existing provisional bridge was able to be re-inserted to cover over the region. Recovery was good and led to four crowns being placed, two on implants and two on teeth.

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Immediate replacement of a mandibular premolar

By Dr. Peter Hunt

A mandibular premolar has resorption and the labial bone plate is low. There is not much room to place an implant. This case may not make for an easy transition. See how all these issues were taken into consideration and managed. A smooth transition was accomplished.

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Densification of an implant channel while raising a sinus floor

By Dr. Maurizio Ciocci

A novel range of burs mostly running in reverse have the ability to expand and at the same time “Densify” an implant channel. They also have the ability to raise a sinus floor as is shown in this case.

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The strange story of a blow-out lesion and a migrating gingival margin

By Dr. Peter Hunt

A maxillary central incisor with rapid periodontal breakdown is removed and replaced with an implant where the original root is used as a provisional restoration. Everything goes well but then the labial margin starts slipping. A fast transition to a provisional abutment and crown allows the situation to recover. This case shows the advantage of close observation during the early healing stage

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