Implants GBR & 2nd Stage uncovering

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Posted on By Maurice Salama In Implants

Patient presents after failed implant. Multiptle Ritter implants placed after failure healing with GBR. and stage and uncovering show good bone regeneration and bone to implant contact on PA radiograph. Thoughts and discussion. Dr. Salama

Healing after removal of failed implant
Ritter implant placed

Bone graft area
PRGF Fibrin

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Follow up

Palacci Roll
1 year temp


Preop and post op Pa RADIOGRAPHS

PA preop
PA post op 1 year


Thanks for posting Maurice. Case looks great. I'm having inconsistencies with my PRGF fibrin membranes. They rarely look this good. Any advice? Looking forward to seeing you in Feb.


Kurt, thanks...see you in Florida at XP. Yes, check out the video by my nurse here on XP on PRGF Endoret process. She explains it all. Also, sometimes just the patient differences regarding quality of fibrins. As for implant system here, notice the fine results and bone to implant response on Ritter Spiral implants. Even the short side 6 X 6 has great bone levels above the fixture with their platform switch. regards Maurice


Mo! Nice case! What kind of Biomaterial did you use? Just the fibrin membrane over it? I love the 2nd stage surgery! Absolutely respectfull with the periostium! Mandatory to prevent some bone resorption. Thanks for sharing! Jose Mompell


Jose; Mineralized irradiated allograft with PRGF endoret. Yes, split thickness is Key for sure!!! Under utilized and poorly understood but very important. regards Mo


Hi Maurice! Congrats for the great result. As you knows I use the fibrin sealant in cases like this without non-resobable or collagen barrier.
I often ask myself if the epithelium competes for real with the bone regeneration. Dogma or reality? Thanks for sharing.
Best reagards


Vincenzo; Good question. I agree but most studies show a hydrolization of overlying Fibrin after 3-4 weeks and this may not be enough time to allow bone to fill prior to soft tissue to enter the defect during healing.....a good study that is needed. regards Maurice