The staged approach on atrohpic ridge using NeoBiotech IS II active fixture and nonresorbable membrane

김석용웃는 copy-crop

Author
Seok Yong Kim, DDS, MSD, CAGS

Private Practice
Seoul, Korea



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Female
60 yrs old
Non-contributory
NKDA
Drink occasionally, never smoked
Extraction #36,37,46
Scaling
Root canal treatment and gold crown on #17
Generalized severe chronic periodontitis

Scaling & subgingival curettage
Open flap debridement
Extraction #26,27,28,38,47,48
Ridge augmentation #36,37,46,47
Implant placement #26,27,36,37,46,47
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Occlusal view of the surgical site under local infiltration injection with 2% lidocaine before incision

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Lingualized crestal incision and full thickness flap elevation

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Horizontal bone resorption has progressed since extraction of #36,37. The remaining horizontal bone width is almost 4 mm. The staged approach has been decided. Decortication has been done.

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0.5 cc of Oragraft and 0,5 cc of A-oss has been grafted.

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OpenTex nonresorbable membrane has been placed on top of the grafted bone. Periosteal penestration has been done to release the buccal flap.

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Horizontal mattress suture has been done to stabilize the membrane. With one key suture, buccal and lingual flaps are approximated.

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Single interrupted suture has been done to adapt the buccal and lingual flaps.

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1 wk follow up photo

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4 months after ridge augmentation procedure

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Slightly lingualized incision and full thickness flap elevation before membrane removal

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Nonresorbable membrane has been removed.

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Guide pins have been inserted after initial drilling.

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Two 5.0*10.0 mm NeoBiotech IS Ⅱ active fixtures have been placed on #36,37 at 30Ncm. Fixture direction pins have been placed to check occlusal relationship.

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Through ridge augmentation with mixture of Xenograft and allograft, up to 5mm of mature bone has been achieved. Enough initial stability also has been achieved with NeoBiotech IS Ⅱ active fixtures on the grafted bone site.

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Two 5.5*5.0 healing abutments have been placed.

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Two splint SCRP PFM crowns have been fabricated and cemented with Fujicem.

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Panorama taken on the day of prosthetic completion

A 60 year old female patient came to the clinic with horizontal bone resorption which had been progressed due to the extractions of #36 and #37. The atrophic ridge was grafted with a combination of Xenobone and allobone, then a nonresorbable membrane was placed over it. After 4 months of the stage I surgery, it was revealed that 5mm of mature bone has been achieved, and Neobiotech IS ll active fixtures were placed on the grafted site achieving enough initial stability.

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