Journal of Oral Implantology April 2014 - (Page 183)

CASE REPORT An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis Cleide Gisele Ribeiro, DDS, MSc, PhD1* Thais Camargo Bittencourt, DDS1 Cimara Fortes Ferreira, DDS, MSc, PhD2 Neuza Maria Souza Picorelli Assis, DDS, MSc, PhD1 Numerous factors may keep surgeons from placing implants in the anterior maxilla in order to avoid suboptimal restorative outcomes. This paper describes a technique of an autogenous-free gingivalÀbone block graft, which allows bone and gingival augmentation and a primary seal to be achieved simultaneously. Additionally, it describes a technique for achieving primary soft tissue closure of maxillary extraction sockets using a rotated pedicle palatal connective tissue flap. Key Words: implants, esthetic, socket, graft INTRODUCTION N umerous factors may restrain surgeons from placing implants in the anterior maxilla in order to avoid suboptimal restorative outcomes. Anterior sites often represent a considerable challenge for clinicians and dental technicians. In this area, various local risk factors have the potential to compromise the predictability of the result.1,2 Several clinical and histologic studies have shown the dynamic resorptive process that unfolds after tooth extraction.3 Clinical measurement of buccal tissue resorption confirms that: (1) the alveolar dimension is dynamic; and (2) resorption occurs even after the placement of a dental implant into an extraction socket.3 Therefore, much interest has been shown towards minimizing or even arresting bone resorption following tooth extraction. In addition, attention has been shown in 1 Federal University of Juiz de Fora, Brazil. Department of Periodontology, University of Tennessee School of Dentistry, Memphis, TN, USA. * Corresponding author, e-mail: cleidegr@yahoo.com.br DOI: 10.1563/AAID-JOI-D-12-00016 2 providing treatment that aims at preserving the natural tissue contours in preparation for a future implant site.4 Currently, most literature in this field results from animal studies.5 Despite some recent advances in bone-substitute technology, autogenous bone grafts remain the ''gold standard'' in reconstructive surgeries due to their osteoinductive, osteoconductive, and nonimmunogenic properties. Autogenous bone can be harvested from extra or intraoral donor sites, which increases the morbidity of the procedures.6,7 Because of this, several factors must be taken into consideration when choosing the donor site, including the location of the recipient bed, the quality and quantity of the required bone graft, and the potential for surgical complications.8 Guided bone regeneration (GBR) is a procedure often employed for an implant site that presents buccal dehiscence or fenestration defects.9 A barrier membrane is necessary for this procedure. Despite soft tissue problems related to membrane exposure, nonresorbable membranes are often preferred because of their inert biological features and the predictability of the barrier effect .10 They also fulfill the prerequisites of an ideal barrier membrane, Journal of Oral Implantology 183

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2014

Consolidated Standards of Reporting Trials (CONSORT): Answering the Call for JOI’s Endorsement
Photoelastic Analysis of Stress Distribution With Different Implant Systems
Influence of Abutment Screw Design and Surface Coating on the Bending Flexural Strength of the Implant Set
Comparison of Implant-Abutment Interface Misfits After Casting and Soldering Procedures
Evaluation of Accuracy of Casts of Multiple Internal Connection Implant Prosthesis Obtained From Different Impression Materials and Techniques: An In Vitro Study
The Effect of Different Implant-Abutment Connections on Screw Joint Stability
Effects of pH and Elevated Glucose Levels on the Electrochemical Behavior of Dental Implants
Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses
Saliva Versus Peri-implant Inflammation: Quantification of IL-1b in Partially and Totally Edentulous Patients
Heat Generated During Seating of Dental Implant Fixtures
An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis
Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management
The Custom Endosteal Implant: Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service
Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report
Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft
Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants

Journal of Oral Implantology April 2014