Block Grafts on Mandible. SSS (Surgical Smile Stent)

2 Rating(s).


Posted on By Jorge Campos In Bone Grafting

To solve this case had to change the prosthesis design, explant 15 implants and solve the vertical bone excess.
BTW, using the bone to solve the thin mandibular crest.
Images are self describing. SSS is usefull for this cases in order to guide us when spliting the upper crest horizontally.
Regards
Jorge




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14 Comments

Little or no bone on buccal. Need to enhance


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Thank you Howie


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Jorge, very well management of the case, now wait the second stage for implants insertion with or not immediate loading.
regards
Vladimir


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Hi Vladimir... It all depends on my torque insertion value. Would be nice to do immediate load!
See you at JTI
Regards
Jorge


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Jorge, in love with your Robin Hood tactic!
Isn`t it sad that 12 implants are placed (with all suffering and $$$) without any analysis, understanding, no plan at all? And that the most common finding on CBCT is like this one that you showed - no buccal bone.
For your SSS - do you perform some art of smile design? What are your steps?
Thank you for sharing!
Cheers
Snjezana


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15 Implants! With a very bad planification. The surgeon who inserted was not the dentist who found a very bad situation. Imagine that you cannot do a fixed and aesthetic prosthesis with that ridge.
1 I removed the prosthesis without anethesia
2 Make her smile and explain that was very important to show me how high does her lip go up.
3 Make a putty silicone roll. Introduce in the mouth , adapt to the ridge and make her smile again. With a composite instrument or any other instrument, make a line at the smile line of the lip.
4 Make her bite the roll to get more stability and reproducibility
5 Introduce the SSS on clorhexidine or povidone.
6 After you raise the flap insert the SSS and mark with pencil the bone.
7 With a diamond disc make the cut. I separated on 3 different blocks. The central block has the anterior pallatal nerve. I had to cut in 2 the block to avoid damage.
Regards dear Snjez
Jorge


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Thanks, Jorge!
Easy and good.
Warm regards, see you very soon
Snjezana


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KLS Martin
3Shape