Bone Banking: 9 months Glöcker SS

39 Rating(s).


Posted on By Jorge Campos In Sinus Augmentation

A patient had to remove a 2nd upper bicuspid. By that time, late december 2016 she was not capable to do immediate implant placement due to financial problems. We decided to do a SS and apicoectomy simultaneously, without implant insertion. We filled the socket with allograft but without any membrane. The results, after 9 months was: excelent crest maintenance and soft tissue invation and filling the socket. This 2nd surgery cleaned all soft tissues on the socket and prepare a sinus lift with Densah burs and insert the implant. Covering the implant with PRF and the flap. Insertion torque values were higher than 50 Nw.
Regards
Jorge




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11 Comments


Reply

Final sutures with PRF


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Jorge

That is simply beautiful

Rocco


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Thanks my friend! This is everyday practice at my office. The lesson to learn is:
1 Buccal bone is maintained with Glocker approach
2 No membrane...no bone. Just a radiopaque image that mimics the bone.
3 Densah burs made this case easily resolved.
Regards
Jorge


Reply

Great case Jorge as usual!!! With regars to ST invagination

Do you find it happening routinely?
Do you think the membrane is a must?
Is it related to the level of the PET (1mm above or level with crest)
Is it related to flap advancement or not?
Is it related to site overfilling with graft or not?

True questions, looking for your feedback.

What I have been doing and have not yet seen this
A) pet is level with bone and I even perform inward beveling towards the socket
B) I flap but I only replace the flap, do not coronally advance
C) i overfill and cover everything with the BRG, no root or implant is visible. BRG used FDBA.

Maybe it works fine or maybe I have not done enough numbers to see this yet.


Reply

Hi Ioannis, thanks for your kind words....
Good questions! Really important.
1 Yes, for my happens routinelly: everytime a member of my team or me, does not use membrane...soft tissue invation
2 Not related to Shield level
3 Not related with site overfilling

Your procedure is correct.
Shield bone level is fine. 1 mm above also.
Shape beveled inwards is necessary for prosthetic reasons.
I don´t regularly fill the gap between Shield and implant. Soft invasion is usually 3 mm at maximum.
Regards and hope to see you soon.
Jorge


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Thanks Jorge! Much appreciated! Hope to see you soon too my friend!


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Great job


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Thanks James!


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Professor,

Well thought out , well managed - well presented- you know how I feel about your cases!!

Cheers,

Richard


Reply

Hi Martin!
Thanks for your kind flattering words!
The issue here is how easily we get confused by the radiographic image of a "filled" socket.
Regards
Jorge


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