Bone Grafting and Healing Abutment Placement at Implant Site #36
Implant Placement
Implant Placement
Chief Complaint
Patient reported loss of Dentium 7.5mm (M) healing abutment at implant site #36.
Clinical Findings
Soft tissue overgrowth obstructing re-insertion of healing abutment at #36 implant.
Loose bone fragment noted on mesial and buccal surface of implant #36.
Gingival overgrowth around implant #36.
Radiographic review revealed:
Periapical lesions on #13 and #14 (part of bridge abutment with #23).
Caries under bridge abutments #13 and #14.
Treatment Plan
Removal of soft tissue overgrowth.
Replacement of healing abutment at implant site #36.
Guided Bone Regeneration (GBR) with autogenous bone grafting and use of Geistlich Mucograft.
Post-operative CBCT to confirm graft placement and proximity to anatomical structures.
Future review and possible restorative management of bridge/caries at #13, #14.
Pre-operative Assessment
CBCT previously reviewed; follow-up imaging delayed due to system error.
Physical examination revealed inflamed and overgrown soft tissue at implant site.
Informed consent obtained after discussing procedures, risks, and benefits.
Anesthesia
Local anesthesia administered: Inferior Dental Nerve (IDN), Lingual Nerve (LN), and Long Buccal Nerve (LBN) blocks.
Surgical Procedure
Patient prepared and draped under aseptic conditions.
Flap raised extending to the ascending ramus.
Granulation tissue debrided from around implant #36.
Implant surface cleaned and irrigated with saline.
Autogenous bone harvested using trephine and chisel.
Bone crushed and packed around implants at #36 and #37.
Geistlich Mucograft (15mm x 20mm) placed for guided bone regeneration.
Sutures placed:
Surgipro Polypropylene 6/0 x 8 (around #36 & #37 implants)
BSS 4/0 x 5 (around #38 and harvest site)
9.Healing abutment 6.5mm (M) placed on implant #36.
10.Post-operative CBCT taken (after system glitch resolved).
11.DN preserved and not compromised.
12.Pictures taken before and after the procedure.
Post Operation Gallery
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Post-operative Assessment
CBCT previously reviewed; follow-up imaging delayed due to system error.
Physical examination revealed inflamed and overgrown soft tissue at implant site.
Informed consent obtained after discussing procedures, risks, and benefits.