27 year old female was previously had motor-vehicle accident sustained multiple facial bone fracture, dento-alveolar fracture with avulsed teeth, #13,#12,#11,#21 and #22. Post-trauma she requested for replacement of her missing teeth but her upper anterior residual ridge was severely resorbed. In this case, I manage to augment back her severely resorbed upper residual ridge with autogenous cortical plates with simultaneous Neobiotech IS II implant placement. Implant surgery was fast and accurate with the use of Neo Navi Guide Kit.

Missing #13,#12,#11,#12 with narrow and resorbed upper alveolar ridge post-trauma

CBCT shows labial wall defect

Implant virtual planning base on the final prosthesis position

Neo Naviguide kit was used together with the 3D printed surgical guide. Neobiotech ISII fixture position was placed according to our previous virtual planning.

Autogenous cortical plate harvested from lateral ramus using piezo electric surgery

Previous cortical plate split into 2 pieces and fixed an the labial wall defect with titanium screws.

Allograft was packed into the remaining bony defect around the implants and covered with resorbable collagen membrane

Healing process

Minimally invasive exposure of the implants with Neobiotech tissue punch and placement of healing abutment.

Final result after delivering the prosthesis

Intra-oral picture comparing before and after final prosthesis

Extra oral picture showing good facial harmony when smiling

Good upper lip support with the prosthesis

3D & CBCT image showing marked increased in anterior-posterior volume of the upper alveolar ridge and good implant position as pre-planned before the surgery.

Conclusion:

Autogenous cortical plate has predictable outcome and can be use as an option for augmentation of severely resorbed alveolar ridge. Simultaneous implant placement with guided surgery definitely decreased surgical time and visits together helping clinician to achieved precision and accuracy in implant surgery.