[2008 21th_case1] Horizontal Ridge Augmentation with Block Bone through Xenografts
Horizontal Ridge Augmentation with Block Bone through Xenograft
Dr. Jang Myong-jin of Sung book ENE Dental Clinic
Picasso Trio SC
Patient Info. : Female / 30 years of age Clinical history :Fracture of the Facial Bone / Node & loss of teeth due to an accident. Treatment region: #11, 12, 13 Condition before Implant placement : Shortage of both Vertical Ramus and Horizontal Ramus
Treatment plan : I had given her an explanation about the plan for Implant placement after Bone Graft. However, she was frightened about it. So instead, I made a plan to perform Implant placement with Xenograft.
CT Assessment before the treatment :The lengths of Vertical Rami were lower 3~4mm than at #21, 22, 23. And the thickness of Horizontal Rami were thin ; 4~6mm
Treatment
- #11 : Diameter 3.75mm / Length 13mm
12 : Diameter 3.3mm / Length 13mm
13 : Diameter 4.0mm / Length13mm
=> On the basis of these information, I have carried out Implant Placement.
- I performed Xenograft by utilizing PRP
- Utilizing absorptive Membrane
- Second treatment after 3 months
- After linking an Abutment, I set a temporary crown and then I finally pressed a denture
3 months after the setting.
CT Assessment after the treatment
-. Increase in the thickness of the Bone from 3mm to 5mm at the Lingual side based on X-
ray the image taken.
-. Oftentimes, it takes 18 months for the fixation of the Bone Graft. Therefore, in this case,
it needs for me to check the condition of the Bone thickness at an interval of 6 months.
-. The increase of vertical Ramus was only 1~2 mm.
-. The margin was up compared with #21, 22, 23.
-. However, the thickness of Horizontal Ramus was the same as in the upper left quadrant
and I could not find the gap of the Papilla between the Implants
Evaluation after the treatment
-. Inspite of the non-Autograft, the Horizontal Ramus recovered after the PRP and
Xenograft. Besides, the Papilla revived well. Although this case was successful in
the patient’s position, as Implantologist, I think a treatment with Autograft to obtain
more quantity of Vertical Ramus would have been better than the above treatment.
In addition, I was able to exactly check the condition of the Bone before and after Bone
Graft through CT diagnosis.
E-mail : implant2000@hanafos.com
E-mail : dentalct@e-wootech.com
Panoramic Diagnostic Images
Panoramic view before the treatment
Panoramic view after the treatment
Dental CT Diagnostic Images
This is a magnified Panoramic View in Cross-Section function. We can adjust the thickness of the Panoramic View from 0.1mm to 30mm. Shown above is an image in 0.3mm thickness.
This is a Cross-Sectional View of #13. After moving the Axial axis on Sagittal view to match the occlusal angle, we were able to make more accurate assessments on the Cross-Sectional view.
Shown above is a Cross-Sectional View of #12. By utilizing the mouse wheel button on the sliced image, we were able to check any sliced image in the range.
This is a Cross-Sectional View of #11. Through this function, we were able to get exact measurement of the length of the Alveolar Bone.
This is an Axial View of an Implant simulation at #11, 12, & 13. We were able to get accurate measurement of the width of the bone which we were not able to exactly measure at the Panoramic View.
Shown above is a Cross-Sectional view after Implant simulation. Before the treatment of #13, we were able to choose the suitable Implant model and to check the exact angle through the Implant simulation.
Through the Cross-Sectional image of an Implant simulation on #12, we were able to check the exact correlation between the Alveolar Bone and the Implant.
This is a magnified 3D view after Implant simulation. Through this, we were able to get exact assessments and thus, effectively communicate with the patient upon consultation.
Oral Images
Dental CT Diagnostic Images
Shown above is a Cross-Sectional view. Through this, we were able to check the condition of the Alveolar Bone around the Implant at #13.
Shown above is a Cross-Sectional view of #12. We were able to check the condition of both the Alveolar Bone and the Implant through this image view.
This is a Cross-Sectional view of #11. Through the cross-sectional view, we were able to check the condition of the Alveolar Bone at #11 prior and post treatment operation.
Shown above is a magnified 3D view in General Curve function. After eliminating the Soft and Hard Tissues having low bone density through Fine Tuning, we were able to check the path for the Implant by assessing the Implant and the Enamel in 3D image.
