Resolving a soft tissue complication in a GBR procedure

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Author
Dr. Manuel Feregrino Mendez DDS

- Specialist in Periodontics, Intercontinental University. Mexico City

Specialist in Implantology Andres Bello University. Santiago de Chile
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Author
Dr. Federico Baena Quijano DDS

- Specialist in prosthodontics and implant Dentistry. University of La Salle, LEON Guanajuato

- General Dentist, University of The Valley Of Mexico

- Creator Of a YouTube channel regarding dental topics with over 260,000 subscribers
28 years old male patient without systemic disease, he lost his upper lateral incisal 2 years ago in a car accident.

Previous CT scan where we have 3.27mm crestal bone width, not enough for implant placement on the upper right lateral incisor.

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The treatment plan was a simultaneous IS-II implant placement with a Guided Bone regeneration with a A3 titanium membrane and a xenograft, covered by membranes by Plasma Rich in Growth Factors.

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4 months later, the patient presented a soft tissue fenestration with a titanium membrane exposure.

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At the time of membrane removal, we found good bone volume enough to continue with the procedure.

In order to resolve the soft tissue defect and prevent a bone infection, we opened the flap then removed the titanium membrane and we took a connective tissue graft from palate.

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Placement of connective tissue graft under the flap in order to cover the bone and fill the holes left by the soft tissue fenestration.

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Implant stability of 73 checked by Any Check at the time of membrane removal and implant uncovering.

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One week healing

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One month healing

6 months follow-up after restoration

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6 months follow-up after restoration, where we can see the new bone regeneration from 3 mm to 6.9 mm width

Even with a soft tissue complication, the GBR is a predictable procedure if we know how to resolve it.

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