Space Maintenance Using Tenting Screws in Atrophic Extraction Sockets

(a and b) Schematic representation of GBR of the atrophic extraction socket using tenting screws.

(a) Right central incisor (#8), Hemi-septal defect on the mesial with a compromised buccal plate of bone. (b) #8 extracted and socket debrided. (c and d) Tenting screw in place. (e) Socket grafted with particulate bone and covered by resorbable membrane. (f) Fixed provisional to prevent premature loading of the graft site. (g) At 4 months, a follow-up radiograph was taken, showing radiographic bone fill to the level of the screw.

(a) The mandibular right first molar was deemed hopeless due to an endo-perio lesion. (b) The tenting screw was placed buccally in the defect. (c through e) Particulate bone graft and resorbable membrane were placed and tension free primary closure was achieved. (f) At 4 months, 2 platform-switched 3i/Biomet fixtures were placed. (g) The final restorations were placed with sufficient embrasure spacing as well as an adequate band of attached keratinized tissue.

(a and b) Preop radiograph and tenting screw placement. (c and d) Radiographs showing healing process with tenting screw GBR. (e and f) Shows the radiographic progression of implant placement at the time of surgery, parallel pin, test body implant, and placement of a 4/3mm × 11.5mm 3i. (g) Following 3 months of healing, the implant was uncovered and platform switched, and referred for a final restoration. (h) Final radiograph taken after 3 years. The crestal bone level has been maintained and the implant is stable. (i) Clinical picture of implant #4 taken at 3 years postop.