2 Stage Lateral Augmentation - No Spongy Bone & Poor Blood Supply

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Posted on By David Baranes In Bone Grafting

Patient of around 40 years of age who came to consult for implant treatment in 28 and 29. 29 is mobile.
After the CBCT examination, the ridge is very thin and the quality of the bone is type 1 - dry and with very poor blood supply.
We decided to extract 29 and perforate the vestibular cortex, and apply 3D Bond for 7 weeks to revitalize the surrounding bone.
When the site is reopened, the bony environment is quite different, highly vascularized, and at this stage, is more suitable for bone grafting. It is important to note not to remove the new vascularized tissue and apply directly to it Bond Apatite as the long term space maintainer in order to reach the desired volume.
After another 3 months, we reentered the site and were very satisfied to find a ridge of about 8 mm in thickness, ready for implants to be placed.

Pre op
Pre op

Pre op
Operation 1


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5 Comments

7 weeks post op, the site is now well vascularized
Placed Bond Apatite directly on the vascularized newly formed tissue.


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CBCT 3 months post 2nd stage (5 months total)
Reentry clinical appearance


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Implants in place


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Impressive truly. What are the particles that have not resorbed? Thanks for sharing. Dr. Salama


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Thank you Dr. Salama. The remaining particles are the large HA particles, which are about 10% of the graft and they are also in a process of resorption and will transform to the patient's own vital bone in additional few months. Dr. Baranes


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