Vertical bone augmentation with Tent screw and CTi-mem

허영구 원장님 Dr. Heo

Author
Dr. Young-Ku Heo, DDS, MDS, PhD

Director of Global Academy of Osseointegration
Seoul, Korea



#24 and 25 had advanced periodontal disease with severe vertical bone resorption.
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Clinical buccal view after extraction of #24 and #25 showed severe vertical defect.

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A periapical radiograph showed severe bone defect. However, proximal bone of both #24 and #25 were intact so it was possible to build up bone up to the line.

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A clinical buccal view showed severe vertical bone defect without buccal and lingual bony walls. A Tent screw was inserted instead of an implant to create vertical space.

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An allograft (RegenOss, FDBA) was applied to the defect up to a height of Tent screw.

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Two titanium meshes (CTi-mem, Neobiotech) were fixed on the Tent screw.

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A collagen membrane (CollaTape) was placed over the titanium meshes for minimizing mesh exposures.

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Mattress key sutures were made to decrease exposures.

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The soft tissue has healed without membrane exposures.

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Panoramic view showed a vertical augmentation with a Tent screw.

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An incision was made to expose the titanium mesh at 6 months of the GBR procedure.

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The CTi-mems were easily removed.

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The large vertical defect was fully regenerated with new dense bone. It might be due to vertical space maintained with a Tent screw and titanium meshes.

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Periapical radiograph shows the amount of vertical augmentation.

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An occlusal view shows good buccal bone regeneration.

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Preop.

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6 months postop. Approximately 7mm of vertical new bone was gained.

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Enough buccolingual bone width was regenerated.

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2 internal type of CMI IS ll active implants were placed in the regenerated bone.

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2 implants were placed with 40Ncm of initial stability in the D3 bone density.

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2 healing abutments were connected and the wound margins were closed with sutures.

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Panoramic view after implant placement.

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Periapical view after finishing the prosthesis.

Before and 6 months after the bone augmentation. Approximately 7mm of vertical new bone was gained.

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