Klinischer Erfolg mit dem richtigen Regenerations-Konzept

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Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Initial situation – Treatment plan: Replace the adhesive upper left central incisor bridge with a dental implant

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Advanced bone loss after traumatic tooth loss more than 10 years ago

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

CBCT: Advanced bone loss after traumatic tooth loss more than 10 years ago

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Patient used to have a diastema in the area which she no longer wanted to be recreated. Treatment plan: implant for UL1 and a veneer for the UR1 to match the space analysis and achieve acceptable and symmetrical aesthetic outcome

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Three-sided full thickness flap and cleaning the surgical area from the granulation tissue

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Three-sided full thickness flap and cleaning the surgical area from the granulation tissue

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Shaping and preparing the uni-cortical maxgraft® block using straight hand-piece under copious irrigation to fit the surgical field and to ensure good adaptation

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Shaping and preparing the uni-cortical maxgraft® block using straight hand-piece under copious irrigation to fit the surgical field and to ensure good adaptation

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Stabilisation of the bone block with two 10 mm fixation screws placed oblique. Sharp edges of the block were polished to avoid defeasance in the soft tissue healing

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Stabilisation of the bone block with two 10 mm fixation screws placed oblique. Sharp edges of the block were polished to avoid defeasance in the soft tissue healing

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Layer of maxgraft® cancellous particles used to fill any gaps and to allow smooth contour medially and distally and covering with Jason® membrane

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Layer of maxgraft® cancellous particles used to fill any gaps and to allow smooth contour medially and distally and covering with Jason® membrane

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Soft tissue adjustment - frenulum adjustment and muco-periosteal release to achieve full closure under no tension to allow the flap margins to heal with primary intension

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Soft tissue adjustment - frenulum adjustment and muco-periosteal release to achieve full closure under no tension to allow the flap margins to heal with primary intension

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Flap closure using 5/0 monofilaments Prolene sutures

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Flap closure using 5/0 monofilaments Prolene sutures

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Six months healing period was allowed - healthy soft tissue contour, satisfactory convexity

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Six months healing period was allowed - healthy soft tissue contour, satisfactory convexity

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Post op CBCT shows well integrated and remodelled bone block with sufficient augmentation

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Post op CBCT shows well integrated and remodelled bone block with sufficient augmentation

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Osteotomy prepared revealing a well integrated and nourished bone block. Prostheticly driven implant placement (Straumann Roxolid BLT - RC 4.1x 10 mm) - using a pre-fabricated surgical guide of the approved wax up

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Osteotomy prepared revealing a well integrated and nourished bone block

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Implant is placed 3 mm away from the cementoenamel junction. Good primary stability was achieved with a torque of 35 Nom at placement and good block integration

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

4.5 mm diameter x 4 mm height healing abutment

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

GBR at the time of the implant placement - added cerabone® 0.5 cc small particles to increase the convexity and insure stability of the soft tissue. Jason® membrane stabilised with titanium pins and sutured palatally

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

GBR at the time of the implant placement - added cerabone® 0.5 cc small particles to increase the convexity and insure stability of the soft tissue. Jason® membrane stabilised with titanium pins and sutured palatally

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Exposure of the UL1 implant and fitting a chair side temporary crown

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Exposure of the UL1 implant and fitting a chair side temporary crown

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Final implant impression with Straumann RC customised impression pick up with an open tray for final screw retained implant crown on UL1 and Porcelain veneer on UR1

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Final implant impression with Straumann RC customised impression pick up with an open tray for final screw retained implant crown on UL1 and Porcelain veneer on UR1

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Final fit of final screw retained implant crown with CAD/CAM Ti abutment on UL1 and Porcelain veneer on UR1. Lab work was provided by Ceramist Guglielmo Parziale - Napoli - Italy

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

5 years clinical review – stable outcome

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

5 y post op CBCT - Axial view at the coronal 2mm level

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

5 y post op CBCT - Coronal view showing the upper left central incisor implant

, Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

5 y post OP CBCT -Sagittal view