Immediate Implant Dual Zone from 2013. Slow and gradual resorption.

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Posted on By Maurice Salama In Failures

Immediate Implant #9 Dual Zone from 2013. Slow and gradual resorption. See images from 2013 Sx, 2014, 2015, 2016 and today 2017. Difficult to predict but we know this occurs to a varying degree in all cases. Today, we must consider PET or SVG or Delayed approaches if we are to avoid these situations. Thoughts?? Dr. Salama

2017
2013 Extraction

Dual Zone
2013 Immediate temp at 3 months


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12 Comments

Thank you for sharing...it is so important!
Nowadays I see it this way: if PET not possible, than SVG. If delayed - "prosthetic socket preservation" with fixed provisional and pontic supporting the buccal soft tissue, to reduce a ridge collapse, frenulum displacement...and obligatory CTG with implant placement (and in >80% of all cases GBR).
What do you think, if you had thickened soft tissue with CTG in 2015, would the resorption be avoided?
Best regards
Snjezana


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Great Question Snjezana, not sure avoided but masked....compensated for and more maintainable. Now time for CTG recovery here for sure....Happy holidays. Maurice


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De acuerdo con usted Dr. Salama . En este caso en particular por lo que se puede apreciar en las fotografías clínicas , aparece una complicación a partir del 2014 , que se observa una pequeña fístula a nivel marginal. Como lo trato en ese momento ? Pudo haber sido una colonización localizada que haya causado tal situación ? Espero su respuesta y muchas gracias por compartir. Saludos Eduardo.


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Time......tells a story.

2014 Soft Tissue
2017 Soft Tissue


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Thank you Maurice! How many cases of immediate implantation we have made and we said that we had stayed well ... and years later we observed a loss of buccal volume. How much we have grown ... how much we have learned ... we already know what is happening ... Apache Socket shield, PET and we begin to see different things ... preservation of the buccal bone crest ... we are on the right track. Now, we have all these cases that we have "failed", GBR ... CTG ... APRF ... much to learn!


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Eye opener!


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Alberto & Yiannis; We must be honest, share and EVOLVE!!!!
Thanks Maurice


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Here is 8 year post extraction of central incisor with no buccal plate and immediate tuberosity CTG socket-fill graft. No sutures used. Graft kept in place by provisional bridge.


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Paul....nice result..What is the point you are trying to make? Merry Christmas and see you in Florida in February. regards Mo


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My observation is that dense vital tissue like Tuberosity CTG may resist contraction over time.
Happy Holidays. See you in Fla.


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Paul; I completely agree with your assessment. In your case it was used for a pontic under a brige, would you also utilize it at the time of immediate implant placement? I have difficulty using it in those situations. regards and merry christmas. Mo


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Maurice, thanks for your honesty! You are great also for this.
I've learned from my negative experience & evidence that we would perform (if buccal bone <1.5mm) a veneer graft when it's impossible (today) a PET. Naturally CTG if thin byotipe.
Merry Christmas!
Enzo


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BTI
KLS Martin