Dr. Giorgio Tabanella

Guided bone regeneration with immediate implant placement

Using NobelReplace® CC, creos™ xenoprotect and creos™ xenogain

Dr. Giorgio Tabanella

Italy

Case courtesy of Dr. Tabanella

Clinical situation: Implant treatment in tooth position 15 (FDI system) after failure of endodontic treatment.

Surgical solution: Immediate placement of NobelReplace CC implant and simultaneous guided bone regeneration (GBR) using creos xenogain as bone graft material and creos xenoprotect as barrier membrane to close fenestration and increase buccal bone. Creos xenogain was also used for socket grafting.

Restorative solution: Immediate provisionalization and delivery of the final prosthetics after 4 months.

Total treatment time: 4 months – with 6 years follow up.

 

 

 

Case courtesy of Dr. Giorgio Tabanella.

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Initial clinical situation

Case courtesy of Dr. Tabanella

Pre-operative pictures. Clinical picture: Tooth removal after failure of endodontic treatment.

Initial clinical situation 

Case courtesy of Dr. Tabanella

CBCT scan.

Surgical procedure

Case courtesy of Dr. Tabanella

Guided bone regeneration and implant placement.

Extraction of the tooth. Fenestration on the buccal aspect and thin buccal plate.

Surgical procedure

Case courtesy of Dr. Tabanella

Guided bone regeneration and implant placement.

Immediate implant placement and simultaneous GBR to close fenestration and increase buccal bone as well as socket grafting. creos xenogain was used as bone graft. creos xenoprotect membrane was trimmed thanks to its good handling properties and stabilized interproximally using pins.

Restorative procedure

Immediate provisionalization.

NobelReplace CC implant, after suturing and placement of an immediate temporary abutment (left).

X-ray after implant placement (center).

Immediate placement of a temporary crown (right).

Outcome

Case courtesy of Dr. Tabanella

Final restoration.

Placement of the final restoration after 4 months (left, center).

Follow up after 6 years, growing papilla and healthy soft tissues (right).

Outcome

Case courtesy of Dr. Tabanella

CBCT scan before and after treatment.

CBCT scan – pre-operatively (left).

CBCT scan after a six years, showing increase in buccal wall thickness (right).

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