Buccal Concavity Regeneration Strategies

91 Rating(s).


Posted on By Bernardo Mira Correa In Implants

Bone collapse following tooth extraction can be a major complication from both aesthetic and functional points of view.
Having a versatile armamentarium, such as extra-short implants, PRGF-ENDORET, trans-epithelial abutments, etc., can help us overcome the challenge, of performing hard and soft tissue's regeneration, in a simpler and predictable way.




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18 Comments

Nice bulk....


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Indeed Mo! i guess we achieved a pretty good outcome !
Thanks


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Bernardo, I envy you for this case!
What have you done for horizontal ridge augmentation?
Great outcome and stability!
Best regards
Snjezana


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A modified Fouad Khoury approach. Since it was a thick periodontal biotype, no soft tissue augmentation was needed.(Although we know that PRGF-ENDORET by itself will promote epithelial thickning after healing).


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Oh I am in love Bernardo. beautiful handling of this case and the bulk is incredible. I would love to see a post op CBCT of the case to see what the buccal thickness of bone looks like. Well done


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Hi Howie! Thank you so much for your kind words!
I'm lecturing in Ecuador during this week. I Will post the cbct control when i return!
Best regards
Bernardo


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Great, autogenous! Perfect case!
Thank you for sharing, Bernardo.
Cheers
Snjezana


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Great result. Intraoral cortical grafts are very predictable. Do you have any studies that support your statement that PRGF causes epithelial thickening There is so much misinformation on platelet concentrates I like to separate the "possible" and the "reality"


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Craig the epithelial thickning is close to double.
Actually the RCT Bernardo told you about is one the most incredibley designed i have ever read. It's a good investment to read it.


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It was an interesting paper but the "devil is in the details" as they say


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Hi Craig! Yes there are ! I can send you a randomized controled trial to your e-mail if you want


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Bernardo, Thank you for the socket graft study using PRGF (Anitua et al, 2014). The mean thickness of the keratinized gingiva with PRGF was 415 microns (+/- 141). The thickness with a blood clot was 275 microns (+/- 36). The mean difference was only 141 microns or 0.141 millimeters (only 50% thicker not double). In addition, this model is a socket healing by secondary intention not a mucoperiosteal flap. The statements that “PRGF-ENDORET by itself will promote epithelial thickening after healing” and “the epithelial thickening is close to double” give the impression that this contributed to the enhanced restoration of the ridge contour. I think you would agree from the study that any soft tissue thickening by PRGF is clinically insignificant and bone augmentation is the main reason the contour was improved. This was a beautifully executed case with a great outcome. Thank you again for sharing your knowledge.  


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I sent it to you! it's definitively worth reading!
Best regards
Bernardo


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Outstanding result. Bravo !!
Where did you harvest the blocks?

Best regards,
Ehab


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Hi Ehab! thank you fro you kind comment!
The bone block was harvested from the sinus lateral wall with piezzo.
One good advantage is that it already comes with the adequate thickness, to perform the F.Khoury block grafting technique. On the other hand, we end up with only one surgical area.
Best regards
Bernardo


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Bernardo great case and results. How much time did you wait before loading? Did you went with provisionals and then moved to the final restorations?
Beautiful management, congratulations.
Thanks for sharing!


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Hi Manuel!! Thank you for commenting on this post!
In this case we waited around 3 months.
Then Went with acrílic provisionals for a couple of months more (progressive functional loading), and then we went on with the definitive crowns. (Also splinted).
Best regards
Bernardo


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Omnia
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