Implant Patient with Facial Gingival Dehiscence and Exposed Threads: Recomendations?
Last Updated: Jun 12, 2011
Dr. A. asks:
I am an oral surgeon and I was referred a young female patient with a high smile line, thin biotype, in whom I placed an implant more than 2 years ago. It was restored by a general dentist, using a Zirconium abutment. She came back to see the restoring doctor with a slight facial gingival dehiscence, and exposed threads. But instead of the restoring doctor referring her back to me, he placed composite on the exposed 2-3 threads. She now has more facial dehiscence, facial gingival recession, more bone loss. A CBVT scan shows loss of facial cortical bone only. Clinically the implant is still solid and is not mobile.
After viewing the CBVT scan and discussion with the patient, I decided to remove the implant, graft the area, with bone and soft tissue. What is the best sequence to treat this patient? I was planning on placing a bone graft using an allograft material. What allograft material would you recommend for a situation like this? I am planning on placing Alloderm over the bone graft to compensate for soft tissue loss. I am going to create a pouch for the Alloderm and graft underneath.
Is there another way that produce a more predictable result? Should a place a membrane over the Alloderm and if so which membrane would you recommend? As an oral surgeon, I am really looking for an advice from a periodontist who has had more experience with managing bone and soft tissue defects in the maxillary anterior aesthetic zone.
12 Comments on Implant Patient with Facial Gingival Dehiscence and Exposed Threads: Recomendations?
peter fairbairn
06/13/2011
PCPerio
06/14/2011
Dr. Dan
06/14/2011
Dr. Dorian Hatchuel Perio
06/14/2011
Steven
06/14/2011
gary weider
06/14/2011
Abg
06/15/2011
dr periodontist
06/15/2011
Dr. Samir Nayyar
06/20/2011
Dr Ares
07/09/2011
Baker vinci
07/11/2011
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06/12/2011