Author
Dr. Manuel Feregrino Mendez DDS
- Specialist in Periodontics, Intercontinental University. Mexico City
Specialist in Implantology Andres Bello University. Santiago de Chile
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.
Placement of connective tissue graft under the flap in order to cover the bone and fill the holes left by the soft tissue fenestration.
Implant stability of 73 checked by Any Check at the time of membrane removal and implant uncovering.
One week healing
One month healing
Even with a soft tissue complication, the GBR is a predictable procedure if we know how to resolve it.
2021 Total Views 1 Views Today
![](mailto:?subject=Resolving a soft tissue complication in a GBR procedure&body=
<img class=" vc_box_border_grey " src="http://gaoforum.com/wp-content/uploads/2020/03/인물사진-80x80.jpeg" width="80" height="80" alt="인물사진" />
<br/>Author<br/>Dr. Manuel Feregrino Mendez DDS<br/><br/>- Specialist in Periodontics, Intercontinental University. Mexico City<br/><br/>Specialist in Implantology Andres Bello University. Santiago de Chile
<img class=" vc_box_border_grey " src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-1-11-80x80.jpeg" width="80" height="80" alt="Slide 1-1" />
<br/>Author<br/>Dr. Federico Baena Quijano DDS<br/><br/>- Specialist in prosthodontics and implant Dentistry. University of La Salle, LEON Guanajuato<br/><br/>- General Dentist, University of The Valley Of Mexico<br/><br/>- Creator Of a YouTube channel regarding dental topics with over 260,000 subscribers
<a href="#acc-7-8-d" data-parent="#accordion-7" data-toggle="collapse" class="accordion-toggle">Patient information
</a>
28 years old male patient without systemic disease, he lost his upper lateral incisal 2 years ago in a car accident.
<br/><br/>
<a href="#acc-9-10-d" data-parent="#accordion-9" data-toggle="collapse" class="accordion-toggle">Pre-operative CT and clinical view of #21
</a>
Previous CT scan where we have 3.27mm crestal bone width, not enough for implant placement on the upper right lateral incisor.
<br/><br/>
<a href="http://gaoforum.com/wp-content/uploads/2020/03/1-2.png"><img width="300" height="200" src="http://gaoforum.com/wp-content/uploads/2020/03/1-2-300x200.png" class=" vc_box_border_grey attachment-medium" alt="1-2" /></a>
<a href="http://gaoforum.com/wp-content/uploads/2020/03/1-1.png"><img width="282" height="300" src="http://gaoforum.com/wp-content/uploads/2020/03/1-1-282x300.png" class=" vc_box_border_grey attachment-medium" alt="1-1" /></a>
<a class="kleo-gallery-img"><img width="300" height="199" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-3-18-e1584607023820-300x199.jpg" class="attachment-medium" alt="Slide 3-1" /></a>
<a class="kleo-gallery-img"><img width="300" height="199" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-3-21-300x199.jpg" class="attachment-medium" alt="Slide 3-2" /></a>
<a class="kleo-gallery-img"><img width="300" height="199" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-3-31-e1584607095576-300x199.jpg" class="attachment-medium" alt="Slide 3-3" /></a>
<a class="kleo-gallery-img"><img width="300" height="199" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-3-41-300x199.jpg" class="attachment-medium" alt="Slide 3-4" /></a>
<a class="carousel-prev" href="#"></a>
<a class="carousel-next" href="#"></a>
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.
<br/><br/>
<img width="1024" height="682" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-4-2-1024x682.jpg" class=" vc_box_border_grey attachment-large" alt="Slide 4-2" />
4 months later, the patient presented a soft tissue fenestration with a titanium membrane exposure.
<br/><br/>
<img width="600" height="400" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-5-1-e1584979688536.jpg" class=" vc_box_border_grey attachment-full" alt="Slide 5-1" />
At the time of membrane removal, we found good bone volume enough to continue with the procedure.
<br/><br/>
<a class="kleo-gallery-img"><img width="300" height="187" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-6-1-300x187.png" class="attachment-medium" alt="Slide 6-1" /></a>
<a class="kleo-gallery-img"><img width="300" height="180" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-6-2-e1584980136489-300x180.png" class="attachment-medium" alt="Slide 6-2" /></a>
<a class="kleo-gallery-img"><img width="300" height="200" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-6-3-300x200.jpg" class="attachment-medium" alt="Slide 6-3" /></a>
<a class="carousel-prev" href="#"></a>
<a class="carousel-next" href="#"></a>
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.
<br/><br/>
<img class=" vc_box_border_grey " src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-71-e1585017397804-428x293.jpg" width="428" height="293" alt="Slide 7" />
Placement of connective tissue graft under the flap in order to cover the bone and fill the holes left by the soft tissue fenestration.
<br/><br/>
<img width="1024" height="698" src="http://gaoforum.com/wp-content/uploads/2020/03/Screen-Shot-2020-03-24-at-3.14.18-PM-1024x698.png" class=" vc_box_border_grey attachment-large" alt="Screen Shot 2020-03-24 at 3.14.18 PM" />
Implant stability of 73 checked by Any Check at the time of membrane removal and implant uncovering.
<br/><br/>
<img class=" vc_box_border_grey " src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-92-e1585032471378-428x293.jpg" width="428" height="293" alt="Slide 9" />
One week healing
<br/><br/>
<img class=" vc_box_border_grey " src="http://gaoforum.com/wp-content/uploads/2020/03/Screen-Shot-2020-03-24-at-3.56.58-PM-428x293.png" width="428" height="293" alt="Screen Shot 2020-03-24 at 3.56.58 PM" />
One month healing
<br/><br/>
<a class="kleo-gallery-img"><img class="" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-12-11-e1585034359509-428x293.jpeg" width="428" height="293" alt="Slide 12-1" /></a>
<a class="kleo-gallery-img"><img class="" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-12-21-e1585034565114-428x293.jpg" width="428" height="293" alt="Slide 12-2" /></a>
<a class="kleo-gallery-img"><img class="" src="http://gaoforum.com/wp-content/uploads/2020/03/Slide-12-31-e1585034736543-428x293.jpg" width="428" height="293" alt="Slide 12-3" /></a>
<a class="carousel-prev" href="#"></a>
<a class="carousel-next" href="#"></a>
6 months follow-up after restoration
<br/><br/>
<img width="1024" height="396" src="http://gaoforum.com/wp-content/uploads/2020/03/Screen-Shot-2020-03-24-at-4.31.17-PM-1024x396.png" class=" vc_box_border_grey attachment-large" alt="Screen Shot 2020-03-24 at 4.31.17 PM" />
6 months follow-up after restoration, where we can see the new bone regeneration from 3 mm to 6.9 mm width
<br/><br/>
<a href="#acc-11-12-d" data-parent="#accordion-11" data-toggle="collapse" class="accordion-toggle">Conclusion
</a>
Even with a soft tissue complication, the GBR is a predictable procedure if we know how to resolve it.
<br/><br/>
http://gaoforum.com/resolving-a-soft-tissue-complication-in-a-gbr-procedure/){kind=link}