Complete restoration of a patient with advanced periimplantitis
Complete restoration of a patient with advanced periimplantitis
Prof. Dr. Peter Windisch
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Initial situation: 3 ailing implants with a cantilever bridge construction.
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Occlusal view.
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Radiographically detected periimplant bone loss.
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3D visualized periimplant defect morphology - digital CBCT evaluation.
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Situation after implant removal. The „superficial” (mostly affecting the soft tissue environment) inflammation was eliminated. Healing time 2-6 weeks.
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Situation after implant removal. The „superficial” (mostly affecting the soft tissue environment) inflammation was eliminated. Healing time 2-6 weeks.
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permamem® positioned above the advanced defect configuration. In addition, biotype modification was taken place using mucoderm®.
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After extraction site development. Healing time 6 months.
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Volumetric changes of the hard tissue after extraction site development.
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Planning for alveolar ridge augmentation
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Planning for alveolar ridge augmentation
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Second surgery for alveolar ridge augmentation.
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Horizonto-vertical alveolar ridge augmentation with the application of permamem® above bone microblocks and composite graft consisting of 50% cerabone® and 50% locally harvested autogenous bone particles.
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Situation before flap closure
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Early wound healing
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Situation 6 months after alveolar ridge augmentation before re-entry. (3 months after augmentation a dehiscence occurred, therefore permamem® was removed and Jason® membrane was placed alongside collprotect® membrane).
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Volumetric enhancement of the hard tissue.
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Implant placement in positions 44-45-47.
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Implant placement in positions 44-45-47.
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Simultaneous contour GBR using cerabone® mixed with autologous bone chips and collprotect® membrane.
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Situation 6 months following implant placement.
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Radiographic control.
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implant uncovering.
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Soft tissue augmentation using mucoderm® to increase keratinized tissue thickness.
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Two-layer wound closure.
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Two-layer wound closure.
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Situation 6 months after soft tissue augmentation.
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Abutment connection and final prosthetic rehabilitation: One-time abutments were secured at implant level and final prosthetic work was fabricated on abutment level, therefore dis- or reconnection could be avoided during the process.
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Final prosthetic work.
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Radiographic control.
