Socket preservation
Using creos™ xenogain collagen bone block, creos™ xenoprotect and creos™ pin fixation, magnesium pins
Dr. Liliana Silva
Patient: 17-year-old male (under growing curve), ASA I. Nonsmoker, no excessive alcohol consumption, no uncontrolled systemic conditions.
Clinical situation: Failing root canal in the anterior zone. Tooth position #22.
Surgical solution: Atraumatic tooth extraction and socket preservation using autogenous bone from the tuberosity and creos xenogain collagen bone block, creos xenoprotect collagen membrane and creos pin fixation, magnesium pins. No simultaneous implant placement as patient is still in active growing.
Tooth position: 22
Date of surgery: September 2024
Clinical view
Initial clinical situation before tooth extraction. Failing root canal in position #22.(left).
Initial clinical situation before tooth extraction. Failing tooth in position #22. Occlusal view (right).
Radiographic view
CBCT scan of initial clinical situation. Failing root canal in tooth position 22 in underaged patient (left).
CBCT scan showing dehiscence and fenestration (right).
Atraumatic extraction
Opening of a full thickness flap showing bone dehiscence and fenestration (left).
Atraumatic tooth extraction (right).
Atraumatic extraction
Clinical view after tooth extraction. Bone dehiscence and fenestration (left).
Occlusal view after tooth extraction. Preservation of bone architecture (right).
Collection of autogenous bone
Extraction of the third right molar (left).
Collection of the autogenous bone from tuberosity using a calibrated chisel (right).
Socket preservation
Socket preservation using creos xenogain collagen bone block. Autogenous bone from tuberosity is used to close fenestration (left).
Clinical picture before and after socket preservation (right).
Socket preservation
Fixation of a creos xenoprotect collagen membrane using a prototype of the creos magnesium pins on palatal side. After breakage of the pin the membrane was fixated using an absorbable 6-0 suture. The pins have since been made sharper (left, center).
Buccal fixation of the membrane using magnesium pins (right).
Socket preservation
Usage of the Cheeseburger Technique, consisting of layering bone graft material and collagen membranes to create an optimal environment for bone regeneration. Base layer bone graft, middle layer collagen membrane and top layer bone graft and collagen membrane fixed with creos magnesium pins. Connective tissue graft is placed on top to simultaneously augment soft tissue thickness.
Soft tissue after one month healing (left).
Panoramic X-ray after 1 month healing (right).
CBCT scan of the creos magnesium pins
CBCT scan after 1 month healing. The radiolucent area around the pin on the CBCT scan is due to hydrogen release during the absorption of the pin. It has no functional impact, fades over time and does not influence the healing (left).
CBCT scan after 6 months healing (right).
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creos™ xenogain3 methods of application to meet all your bone grafting needs.
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creos™ xenoprotectcreos™ xenoprotect is a natural collagen membrane for guided bone regeneration (GBR) and guided tissue regeneration (GTR) procedures with outstanding handling properties.
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creos™ pin fixationAbsorbable magnesium or titanium pins for secure and stable membrane fixation.
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