Introduction
This case presents replacement of failing mandibular incisors with extraction, immediate implant placement with GBR and growth factors. The procedures are detailed step by step with practical advice.
Failing lower incisors due to recurrent decay and root fracture.
Buccal bone was noted to be thin and presented with concavity
Thin buccal bone and concavity
Neobiotech IS-II active fixture being placed (3.5 x 13 mm)
Fixture being removed from its convenient carrier
Lingual placement of implants
Excellent primary stability is achieved with the design of IS-II active fixtures
Peri-apical radiograph immediately after fixture placement
Preparation of collagen membrane
Growth factor enriched cortical allograft
Growth factor enriched allograft to cover defects around implant and buccal wall
Periosteal release is needed in order to achieve tension free primary closure
Placement of bone graft material
Collagen membrane in place to cover the graft completely
Tension free primary closure of the surgical area
Essix retainer made using existing bridge
Essix retainer in place as provisional
Complete healing of soft tissue after 3 wee
Uncovery of implants at 3 months show excellent ridge thickness and quality of bone
Placement of healing abutments
Healing of soft tissue after uncovery
Open tray impression technique
Cement retained 4 unit bridge
Final radiograph
Permanent restoration insertion
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