Surgical socket preservation, E shape pontic design

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Posted on By snjezana pohl In Anterior/Esthetic

Both central incisors were hopeless. Socket Type 1: pontic shield, Xenograft, FCTG. Socket Type 2: IDR. Prosthodontics: Magdalena Miletic Matesic, XP member - E shape design (learned on XP:)) Situation 8 months after the treatment is finished.




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20 Comments


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I can only SMILE at this case and skill/knowledge base. Really great work. What type of ST graft did you use over pontic shield? Was the shield C shaped? Where did you harvest additional CTG to seal PS site? Thanks for sharing. Dr. S


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Thank you, dr. Salama, I`m more than happy for making you smiling.
Shield was C-shaped, socket is filled with Xenograft. I noticed pontic shield movement if the socket is not grafted. CTG could be easily harvested from the same tuber, just by splitting the great tissue towards palatal.

Best regards

Snjezana


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Snjezana, excellent!!!
Also merit to prostho!
Please can you post some pics of the temporary bridge/s
Super case and super outcome.
What we have to remark here is that you made a good diagnosis of each socket and the best treatment option for each, as seen on the results.
Thanks for posting
Jorge


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Dear Jorge,
Magdalena is my dearest prosthodontics, XP member. I wish more of my colleagues would work like Magdalena.
I`ll ask her for the pics.
You summarized very good - it`s nothing about the skills, but selecting the best treatment option.

Thank you, Jorge

Snjezana


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Nice preservation :) Was the IDR socket grafted with xenograft as well? How was the bone part of your IDR graft kept in position?


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Thanks, Naheed. No Xenograft for IDR socket, just IDR. Tuberosity bone was easily wedged into the socket, it has a really nice handling.
See you in New York?
Best regards
Snjezana


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Beautiful case and execution! Gregory


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Thank you so much Gregory!
Best regards
Snjezana


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Snjezana


Nice work- Beautiful result - Few questions being that you could perform pontic S and IDR - consider implant and cantilever or implant both ? with IDR rebuild buccal ? Consider implants being that you are restoring anterior six and have ability to control zeniths? Did you bond palatal of crowns? What are crowns made of ? Milled?

Cheers,

Richard


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My dear Richard,

The bridge is a milled zirconium frame with a layered ceramic. Sorry, not idea about bonding, I have to ask Magdalena.
We haven`t placed implants for the both centrals because it would make more costs.

Cheers

Snjezana


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When you harvest both bone attached to soft tissue from tuberosity how do you close donor site? Dr. S


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Dr. Salama, thank you for coming back to this case.
I haven`t registered any issue with a wound closure after harvesting bone/soft tissue graft from tuberosity. The soft tissue from both sites collapse and the wound can be closed primary.
Just in one case there was a residual defect and I put PRF and covered with PRF membranes. The patient came after one month and didn`t mention any discomfort in the donor area.
The inserts from the cases are attached.
Best regards
Snjezana


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It was a huge defect after removal of failed implants (removed with finger). The case is done two months ago, I`ll post it as soon as patient comes back.


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Huge defect in mandibula. Rather big combined tuberosity graft.


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PRF to fill and cover the residual defect.


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Hi Snjezana;
Fabulous esthetic result. I always have to let the surgeons comment on the other parts of the case.
Regards,
gerald

Aside: I will not be able to be in NYC August 12 as I have a previous event :(


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Dear Gerald, I`m really sorry that you are not coming to NY.
Thank you for your kind words - I wish more of my prosthodontics colleagues would develop as nice as Magdalena.
I act like you - I always read your comments to restorative cases and learn from them.
Best regards
Snjezana


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