Implant Installation With Bone Augmentation and Transmucosal Healing With Demineralized Human Cortical Bone in the Maxillary Anterior Region: Report of 3 Cases
It is well known that a decrease in vertical height and in horizontal width is seen after tooth extraction. Immediate implant placement, originally thought to prevent buccal wall resorption, showed little or no evident decrease of the resorption rate or pattern in animal experiments or clinical studies. Thus, the need for bone augmentation with immediate implantation has been suggested. However, until recently, simultaneous bone augmentation with immediate implant placement was thought to be possible only in a submerged environment. In this report, the harmony of soft and hard tissue was achieved in 3 patients by immediate implant placement and bone augmentation with transmucosal healing in esthetically challenging situations. Further evaluation is needed to monitor hard- and soft-tissue changes on a long-term basis. Implant placement and bone augmentation with transmucosal healing using demineralized bone matrix may be an option in the treatment of the loss of anterior teeth.
(a) Clinical photograph at the initial visit. (b) The occlusal view after installation of the implant. (c) The occlusal photograph showing uneventful healing. (d) The buccal view after the delivery of the permanent restoration. (e) The clinical view showing the prosthesis good in function.
(a) Clinical photograph at the initial visit showing a missing upper central incisor. (b) Buccal view after the flap reflection. (c) Clinical view after installation of the implant. (d) The defect around the implant was restored with an allograft. (e) Buccal view after wound closure. (f) The buccal view at 2 months postoperation revealed good healing with the maturation of the soft tissue. (g) The buccal view of the prosthesis at the final follow-up evaluation.
(a) Initial clinical view. (b) Occlusal view after the reflection of the full-thickness flap, revealing a bony defect of 5.0 × 4.0 mm in size. (c) The remaining defects after implant installation were grafted with human cortical bone. (d) The occlusal view showing a well-maintained ridge and the maturation of the soft tissue. (e) The final photograph showing the prosthesis in function.
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