10-ye
Follo ar
w-up
Early implant placement with filling of a peri-implant defect,
combining an autogenous bone graft with Geistlich Bio-Oss ®
to correct substantial tissue loss (front region)
by Dr. Jean-Pierre Gardella (surgeon) and Dr. Christian Richelme (prosthodontist)
A
Fig. 1 Implant placement.
B
Fig. 2 , A Filling the defect with autogenous bone cores.
Fig. 2 , B Placement of Geistlich Bio-Oss ® to main-
tain volume and protect the autogenous graft
against resorption.
Fig. 3 Geistlich Bio-Gide ® arranged in a double
layer.
B
A
6 months after grafting
10 years after grafting 6 months after grafting 10 years after grafting
Fig. 4, A First x-ray follow-up: final prosthesis in
place after implant loading (6 months after graf-
ting and implant placement).
Fig. 4, B Long-term x-ray follow-up: 9.5 years af-
ter implant loading (10 years after grafting and
implant placement). Fig. 5 Clinical view of the final prosthesis immedi-
ately after implant loading (6 months after graf-
ting and implant placement). Fig. 6 Stable situation 9.5 years after implant
loading, with perfect soft tissue integration, both
on the buccal and interproximal areas, and with
parafunction, both at the natural denture and on
implant restoration (10 years after grafting and
implant placement).
Early implant placement with simultaneous
contour augmentation using GBR
by Prof. Daniel Buser and Prof. Urs Belser
A
Fig. 1 Following the insertion of the screw-type
implant in a correct 3-dimensional position and
the application of a 1.5 mm healing cap, the ex-
posed implant surface can be easily seen in the
region of the crater-like bone defect with a fa-
vorable 2-wall defect morphology.
A
12-ye
Follo ar
w-up
B
Fig. 2 , A The exposed implant surface is covered with
locally harvested autogenous bone chips in order to
promote bone formation facilitating a short healing
phase of around 8 weeks.
Fig. 2 , B Contour augmentation using Geistlich
Bio-Oss ® .
Fig. 3 Geistlich Bio-Gide ® applied in two layers not
only acts as a temporary barrier, but also as a pla-
ce-holder and stabilizer for the graft. The low subs-
titution rate of Geistlich Bio-Oss ® helps to main-
tain the volume of the alveolar ridge over time, key
factor for the long-term esthetic outcome.
B
12 years after grafting 1 year after grafting 12 years after grafting
Fig. 4, A First DVT follow-up: completely intact
facial wall ~2 mm thick (7 years after grafting and
implant placement).
Fig. 4, B Long-term DVT follow-up: completely
stable facial wall around the implant (12 years after
grafting and implant placement). Fig. 5 Clinical findings after the definitive metal
ceramic crown was placed. The esthetic treat-
ment result is excellent (1 year after grafting and
implant placement). Fig. 6 Excellent esthetic outcome, result of the
GBR contour augmentation using autogenous
bone chips and Geistlich Bio-Oss ® , covered by
a Geistlich Bio-Gide ® and primary soft-tissue
closure (12 years after grafting and implant pla-
cement).
7 years after grafting
4