Essential Techniques of Alveolar Bone Augmentation in Implant Dentistry E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1248

Veröffentlichungsjahr: 2022

Beschreibung

Essential Techniques of Alveolar Bone Augmentation in Implant Dentistry

A clinically focused manual of the most important surgical techniques in alveolar bone augmentation, providing key information for managing cases in implant dentistry

The second edition of Essential Techniques of Alveolar Bone Augmentation in Implant Dentistry: A Surgical Manual, Second Edition presents a variety of key surgical bone augmentation techniques for ensuring proper bone width and height for dental implant placement. Enabling clinicians and dental students to rapidly locate information for cases requiring bone augmentation, this highly practical reference covers ridge preservation, horizontal and vertical ridge augmentation, soft tissue grafting for implant site development, tissue engineering techniques, and surgical alternatives to bone grafting in implant dentistry.

Succinct chapters written by a panel of more than 40 international leading clinicians, scientists, and teachers include step-by-step descriptions of each surgical procedure—supported by information on diagnosis and treatment planning and more than 1,000 high-quality clinical images and illustrations. This fully up to date second edition includes new coverage of 3D alveolar ridge defect reconstruction, procedures for vertical bone augmentation in the posterior maxilla, complete arch dental implant treatment using photogrammetry, metal-ceramic transitional maxillary implant rehabilitation, ridge-split expansion using piezoelectric surgery, and more.

• Presents the main techniques for horizontal and vertical alveolar ridge augmentation
• Contains essential clinical knowledge on bone biology, radiographic and prosthetic evaluation, incision designs, and wound closure
• Introduces alternative techniques such as zygomatic implants, pterygoid implants, and All-on-4 procedure for placement of dental implants that circumvent bone grafting
• Combines the most practical and efficient techniques from the First Edition of Horizontal Augmentation of the Alveolar Ridge in Implant Dentistry and Vertical Augmentation of the Alveolar Ridge in Implant Dentistry in a single and concise book

Essential Techniques of Alveolar Bone Augmentation in Implant Dentistry: A Surgical Manual, Second Edition is a must-have for both novice and experienced dental clinicians, implant dentists, oral surgeons, prosthodontists, and periodontists, and an invaluable resource for dental students and trainees.

Leseprobe

Table of Contents

Cover

Title Page

Copyright

Preface

BOOK ORGANIZATION

Acknowledgments

About the Author and the Editor

Contributors

About the Companion Website

SECTION I: Introduction: Essential Clinical Knowledge

CHAPTERS 1.1 & 1.2: Bone Biology and Wound Healing

CHAPTER 1.1: Bone Biology

BONE TISSUE ANATOMICAL ASPECTS

BONE REMODELING AND HEALING

BIOMATERIALS FOR BONE REGENERATION

OSSEOINTEGRATION

BONE LOADING

REFERENCES

CHAPTER 1.2: Wound Healing

OVERVIEW OF THE WOUND HEALING PROCESS

ORAL SOFT TISSUE WOUND HEALING

REFERENCES

CHAPTER 2: Applied Surgical Anatomy of the Jaws

MAXILLA: SURGICAL ANATOMY

MANDIBLE: SURGICAL ANATOMY

SUMMARY AND CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

CHAPTER 3: Radiographic Evaluation of the Alveolar Ridge in Implant Dentistry: CBCT Technology

THE ROLE OF RADIOGRAPHY IN IMPLANT DENTISTRY

ANATOMICAL AND ARCHITECTURAL CONSIDERATIONS FOR TREATMENT PLANNING

ANTERIOR MAXILLA

POSTERIOR MAXILLA

ANTERIOR MANDIBLE

POSTERIOR MANDIBLE

IMAGING CONSIDERATIONS FOR CBCT UTILIZATION

INTERACTIVE IMPLANT TREATMENT PLANNING

SURGICAL GUIDES

NEWER TECHNOLOGICAL ADVANCES

REFERENCES

CHAPTER 4: Prosthetic Comprehensive Oral Evaluation in Implant Dentistry

INITIAL EVALUATION

CLINICAL APPLICATIONS

CONCLUSION

REFERENCES

CHAPTER 5: Alveolar Ridge Defects and Bone Augmentation Techniques: Surgical Algorithm

RIDGE PRESERVATION AND RIDGE AUGMENTATION

BONE DEFECTS, BONE GRAFTS, AND BONE GRAFTING TECHNIQUES

RISK FACTORS IN BONE AUGMENTATION PROCEDURES IN IMPLANT DENTISTRY

MAIN SURGICAL TECHNIQUES OF BONE AUGMENTATION IN IMPLANT DENTISTRY

ALTERNATIVE SURGICAL TECHNIQUES

GRAFT HEALING AND VASCULARIZATION

ALVEOLAR BONE AUGMENTATION DECISION TREE ALGORITHM

CONCLUSION

REFERENCES

CHAPTER 6: Incision Design, Soft Tissue Flaps, and Wound Closure in Alveolar Bone Augmentation Surgeries in Implant Dentistry

INCISION DESIGN IN ALVEOLAR BONE AUGMENTATION SURGERIES

SOFT TISSUE FLAPS IN ALVEOLAR BONE AUGMENTATION SURGERIES

REFLECTION OF THE MUCOPERIOSTEUM

PREPARING FOR WOUND CLOSURE

WOUND CLOSURE IN ALVEOLAR BONE AUGMENTATION SURGERIES

COMPLICATIONS

CONCLUSION

REFERENCES

CHAPTER 7: Biological Rationale of the Surgical Procedure: Bone Augmentation

GRAFT REVASCULARIZATION SOURCES

CONCLUSION

ACKNOWLEDGMENT

REFERENCES

SECTION II: Ridge Preservation

CHAPTER 8: Bone Grafting Materials for Bone Preservation and Augmentation in Implant Dentistry: Surgical Algorithm

AUTOGENOUS BONE GRAFTS

ALLOGRAFTS

XENOGRAFTS

ALLOPLASTS

CALCIUM PHOSPHATES

CONCLUSION

REFERENCES

CHAPTER 9: Guided Bone Regeneration for Extraction Sockets: Ridge Preservation

REVIEW OF THE LITERATURE

SURGICAL TECHNIQUE

CASE REPORTS

DISCUSSION

CONCLUSION

ACKNOWLEDGMENTS

REFERENCES

CHAPTER 10: Platelet-Rich Fibrin for Bone Augmentation in Implant Dentistry

THE EVOLUTION (HISTORY) OF PLATELET-RICH FIBRIN

LEUKOCYTE AND PLATELET-RICH FIBRIN

PROTOCOLS TO PRODUCE PLATELET-RICH FIBRIN VIA HORIZONTAL CENTRIFUGATION

CLINICAL USES OF PLATELET-RICH FIBRIN IN BONE AUGMENTATION

ADVANTAGES OF THE USE OF PLATELET-RICH FIBRIN

DISCUSSION AND FUTURE RESEARCH

CONCLUSION

REFERENCES

SECTION III: Ridge Augmentation: Horizontal

CHAPTER 11: Guided Bone Regeneration with Resorbable and Non-resorbable Membranes for (Mainly) Horizontal Alveolar Bone Augmentation in Implant Dentistry

APPLIED SURGICAL ANATOMY

INDICATIONS AND CONTRAINDICATIONS

BASIC PRINCIPLES OF GUIDED BONE REGENERATION

DESCRIPTION OF SURGICAL TECHNIQUE

CASE REPORTS

POST-OPERATIVE CARE

COMPLICATIONS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 12: Autogenous Block Bone Graft for Horizontal Ridge Augmentation in Implant Dentistry

RECIPIENT SITE ANALYSIS

BLOCK BONE AUGMENTATION TECHNIQUES

REGENERATIVE TECHNIQUES IN BONE GRAFTING

CASE PRESENTATIONS

CONCLUSION

REFERENCES

CHAPTER 13: Allogenic Block Graft as an Alternative to Autogenous Block Graft for Augmentation of Horizontal Alveolar Bone Defects in Implant Dentistry

INDICATIONS FOR ALLOGENIC BLOCK GRAFTS

DISTINGUISHING FEATURES OF IRRADIATED ALLOGENIC BLOCK GRAFTS

MATERIALS AND METHODS

PATIENT SELECTION CRITERIA

PRE-OPERATIVE CONSIDERATIONS

TECHNIQUE OF ALLOGENIC BLOCK GRAFT FOR A SINGLE ANTERIOR TOOTH

TECHNIQUE OF ALLOGENIC BLOCK GRAFT FOR ANTERIOR SEXTANT

TECHNIQUE OF ALLOGENIC BLOCK GRAFT FOR POSTERIOR SEXTANT

DISCUSSION

CONCLUSION

ACKNOWLEDGMENT

REFERENCES

CHAPTERS 14.1–14.6: Ridge-Split Expansion Procedure for Horizontal Bone Augmentation in Implant Dentistry

CHAPTER 14.1: Diagnosis and Treatment Planning

HISTORY

DIAGNOSIS AND TREATMENT PLANNING

REFERENCES

CHAPTER 14.2: Surgical Principles of the Ridge-Split Expansion Procedure

THE MAXILLA IS NOT AN UPSIDE-DOWN MANDIBLE

VASCULARIZATION: VASCULAR PERIOSTEAL FLAP

SECONDARY INTENTION AND WOUND HEALING: RIDGE-SPLIT EXPANSION PROCEDURE AND GUIDED BONE REGENERATION

OSTEO-CONDENSATION OF SURROUNDING BONE

OSTEO-MOBILIZATION OF THE BUCCAL BONE FRAGMENT

CONCLUSION

REFERENCES

CHAPTER 14.3: Mandibular Two-Stage Alveolar Ridge-Split Expansion Procedure

SURGICAL PROCEDURE: MANDIBULAR RIDGE SPLIT

CASE REPORT

REFERENCES

CHAPTER 14.4: Maxillary Single-Stage Alveolar Ridge-Split Expansion Procedure

CASE REPORT OF A MAXILLARY SINGLE-STAGE ALVEOLAR SPLIT PROCEDURE WITH SIMULTANEOUS IMPLANT PLACEMENT

REFERENCES

CHAPTER 14.5: Advanced Ridge-Split Expansion Techniques for an Experienced Practitioner

SINGLE-STAGE MANDIBULAR ALVEOLAR SPLIT WITH A CLOSED FLAP (CLOSED MAND C-SEG)

SINGLE-STAGE ALVEOLAR SPLIT AND IMMEDIATE IMPLANT WITH A CLOSED FLAP (CLOSED C-SEG-I) (FIGURES 14.5.1–14.5.4)

SINGLE-STAGE ALVEOLAR SPLIT WITH AN OPEN FLAP (OPEN C-SEG)

SINGLE-STAGE ALVEOLAR SPLIT AND IMMEDIATE IMPLANT WITH AN OPEN FLAP (OPEN C-SEG-I) (FIGURE 14.5.5)

SPREADER-DRIVEN RIDGE EXPANSION APPROACH (WITH OR WITHOUT IMPLANT) (FIGURES 14.5.6 AND 14.5.7)

CASE REPORT OF ALVEOLAR SPLIT WITH CONICAL PROGRESSIVE OSTEOTOMES

CONCLUSION

REFERENCES

CHAPTER 14.6: Complications of the Ridge-Split Expansion Procedure and Conclusion

CONCLUSION: “10 COMMANDMENTS” FOR THE ALVEOLAR SPLIT

REFERENCES

CHAPTER 15: Ridge-Split Expansion Procedure Utilizing Piezoelectric Surgery for Horizontal Bone Augmentation in Implant Dentistry

INSTRUMENTS TO SPLIT THE ALVEOLAR RIDGE

RIDGE EXPANDERS TO EXPAND THE SPLIT ALVEOLAR RIDGE

RIDGE-SPLIT EXPANSION PROCEDURE WITH SIMULTANEOUS IMPLANT PLACEMENT

MANAGEMENT OF FRACTURED BUCCAL SEGMENT

CONCLUSION

REFERENCES

CHAPTER 16: Minimally Invasive Combined Technique for Vertical and Horizontal Bone Augmentation in the Posterior Maxilla: Alveolar Split with Crestal Sinus Lift

RIDGE-SPLIT EXPANSION PROCEDURE FOR WIDTH-DEFICIENT ALVEOLAR RIDGE

CRESTAL SINUS ELEVATION FOR HEIGHT-DEFICIENT ALVEOLAR RIDGE IN THE POSTERIOR MAXILLA

MINIMALLY INVASIVE SURGICAL TECHNIQUES: ESLI SEQUENCE

VOLUMETRIC (THREE-DIMENSIONAL) ALVEOLAR BONE AUGMENTATION IN THE POSTERIOR MAXILLA

BIOLOGICAL RATIONALE OF THE ALVEOLAR SPLIT AND CRESTAL SINUS ELEVATION PROCEDURES

CASE REPORTS

CONCLUSION

REFERENCES

SECTION IV: Ridge Augmentation: Vertical

CHAPTER 17: Protected Bone Regeneration with Titanium Mesh for (Mainly) Vertical Alveolar Ridge Augmentation in Implant Dentistry

INDICATIONS

CONTRAINDICATIONS

PRE-OPERATIVE PLANNING (T0)

SURGICAL PROCEDURE (T1)

REGENERATION WITH A TITANIUM MESH

TITANIUM MESH REMOVAL AND IMPLANT PLACEMENT (T2)

IMPLANT RE-OPENING AND PROSTHETIC PHASE (T3 AND T4)

CLINICAL CASES

COMPLICATIONS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 18: Autogenous Block Bone Graft for (Mainly) Vertical Ridge Augmentation in Implant Dentistry

RECIPIENT SITE CLASSIFICATION AND DEFECT ANALYSIS

DONOR SITES FOR BLOCK BONE

AUGMENTATION TECHNIQUES

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 19: Pedicled Vascularized Segmental Osteotomy with Interpositional Bone Grafting for Vertical Ridge Augmentation: Posterior Sandwich Osteotomy

POSTERIOR MAXILLA

TECHNIQUE

CLINICAL APPLICATIONS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 20: Khoury Split Bone Block Grafting Technique: Biological Alveolar Bone Augmentation with Autogenous Bone

BIOLOGY OF BONE REGENERATION

AUGMENTATION TECHNIQUES

CONCLUSION

REFERENCES

CHAPTER 21: Alveolar Distraction Osteogenesis for Bone Augmentation in Implant Dentistry

SURGICAL PROCEDURE

INDICATIONS FOR ALVEOLAR DISTRACTION OSTEOGENESIS

ADVANTAGES AND DISADVANTAGES

COMPLICATIONS

CASE REPORTS

REFERENCES

CHAPTER 22: Orthodontic Therapy: Orthodontic Extrusion for Vertical Ridge Enhancement

WHAT IS ORTHODONTIC FORCED ERUPTION?

DESCRIPTION OF THE TECHNIQUE

POSTERIOR TEETH

THREE-DIMENSIONAL BONE REMODELING

LATERAL IMPLANT SITE DEVELOPMENT

MULTIDIRECTIONAL MOVEMENT

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 23: Reconstruction of Three-Dimensional Alveolar Ridge Defects Utilizing Screws and Implant Abutments for the Tent-Pole Grafting Technique

RIDGE AUGMENTATION USING THE TENT-POLE SCREW TECHNIQUE

AUGMENTATION OF A THREE-DIMENSIONAL ALVEOLAR DEFECT UTILIZING A LOW-PROFILE HEALING ABUTMENT AS A TENT-POLE ABUTMENT

DESCRIPTION OF TENT-POLE ABUTMENT (SANTA)

SURGICAL PROCEDURE OF SANTA-1–ASSISTED HORIZONTAL RIDGE AUGMENTATION

THREE-DIMENSIONAL RIDGE AUGMENTATION USING A TENT-POLE ABUTMENT (SANTA-2)

CONCLUSION

REFERENCES

CHAPTER 24: Lateral Sinus Lift/Bone Graft for Vertical Bone Augmentation in the Posterior Maxilla

INDICATIONS AND CONTRAINDICATIONS

PRE-OPERATIVE DIAGNOSIS, PLANNING, AND EVALUATION OF CASE DIFFICULTY

APPLIED SURGICAL ANATOMY

SURGICAL TECHNIQUE

SURGICAL TECHNIQUE: STAGE TWO SURGERY

CONCLUSION

REFERENCES

CHAPTER 25: Crestal Sinus Lift/Bone Graft for Vertical Bone Augmentation in the Posterior Maxilla

ANATOMICAL STRUCTURES

TECHNIQUES

IMPLANT LENGTH IN OSTEOTOME PROCEDURES

POST-SURGICAL CONSIDERATIONS

COMPLICATIONS

CONCLUSION

REFERENCES

SECTION V: Soft Tissue Grafting for Implant Site Development

CHAPTER 26: Soft Tissue Assessment and Grafting for Alveolar Ridge Enhancement in Implant Dentistry

TECHNIQUES

TECHNIQUES FOR PAPILLA MANAGEMENT

SOFT TISSUE TECHNIQUES FOR EXTRACTION SOCKET GRAFTING

CONCLUSION

REFERENCES

SECTION VI: Alternative (to Bone Grafting) Surgical Techniques

CHAPTER 27: Short Implants as an Alternative to Bone Augmentation in Implant Dentistry

CASE PRESENTATIONS

CONSIDERATIONS AND PITFALLS

CONCLUSIONS

REFERENCES

CHAPTER 28: Zygomatic and Pterygoid Implants as an Alternative to Bone Augmentation in Implant Dentistry

ZYGOMATIC IMPLANTS

PTERYGOID IMPLANTS

INDICATIONS

CONTRAINDICATIONS

PRE-OPERATIVE PLANNING

SURGICAL PROCEDURE

PROSTHETIC CONSIDERATIONS

CLINICAL CASES

COMPLICATIONS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTERS 29.1 & 29.2: Complete-Arch Dental Implant Treatment as an Alternative (to Bone Grafting) Surgical Technique

CHAPTER 29.1: Complete-Arch Dental Implant Treatment Using Photogrammetry and Delayed Immediate Loading

COMPLETE-ARCH SITE CLASSIFICATION

FULL-ARCH TREATMENT: RESTORATIVE BUILDING BLOCKS

DISCUSSION

CONCLUSION

REFERENCES

CHAPTER 29.2: Maxillary Full-Arch Staged Ceramo-metal Implant Rehabilitation

CASE REPORT

DISCUSSION

CONCLUSION

REFERENCES

SECTION VII: Tissue Bioengineering

CHAPTER 30: Tissue Bioengineering and Regeneration in Implant Dentistry

BASICS OF WOUND HEALING

BONE BIOLOGY AND GRAFTING

GUIDED BONE REGENERATION

SOFT TISSUE REGENERATION

TOOTH DEVELOPMENT AND REGENERATION

DENTAL STEM CELLS

BONE MARROW STEM CELLS

CELLS, SCAFFOLDS, AND GROWTH FACTORS

CONCLUSION

REFERENCES

Index

End User License Agreement

List of Tables

Chapters 1.1 to 1.2

Table 1.1.1 Factors related to the implant surface that can affect osseoint...

Table 1.2.1 Differences between oral mucosa and skin wound repair.

Table 1.2.2 The Early Healing Score (EHS).

Chapter 3

Table 3.1 Effective radiation doses from different imaging modalities and b...

Chapter 5

Table 5.1 Horizontal bone deficiency decision tree.

Table 5.2 Vertical bone deficiency decision tree.

Chapter 7

Table 7.1 Stratification of bone augmentation procedures by their biologica...

Chapter 13

Table 13.1 Indications for the allogenic block graft.

Table 13.2 Unique features of the irradiated allogenic block graft.

Table 13.3 List of items used for graft fixation.

Table 13.4 Patient selection criteria for allogenic block graft.

Table 13.5 Features to be assessed prior to surgery.

Table 13.6 Anatomical considerations for allogenic block grafts in anterior...

Table 13.7 Surgical considerations for allogenic block grafts in posterior...

Chapters 14.1 to 14.6

Table 14.1.1 Classification of the alveolar ridge width (Tolstunov).

Chapter 17

Table 17.1 Main advantages and disadvantages of protected regeneration with...

Chapter 22

Table 22.1 Implant site development by orthodontic forced extraction: a pre...

Table 22.2 Mean clinical parameters after orthodontic implant site developm...

Table 22.3 Main biological, esthetic, and mechanical advantages of the orth...

Chapter 25

Table 25.1 Original ABC residual alveolar height classification for sinus a...

Table 25.2 Modification of the ABC residual alveolar height classification...

Table 25.3 Osteotome shape and indication.

Table 25.4 Transcrestal sinus floor elevation technique: options, benefits,...

Table 25.5 Transcrestal sinus floor elevation: complications.

Chapter 30

Table 30.1 Summary of growth factors and biological function in wound heali...

Table 30.2 Stem cells from selected areas in dental–dentin–pulp complex.

List of Illustrations

Chapters 1.1 to 1.2

FIGURE 1.1.1 Biomateral particles (red asterisk) surrounded by woven bone (y...

FIGURE 1.1.2 Osteoclast-like cells (red asterisk), osteoblast-like cells (ye...

FIGURE 1.1.3 Immunohistological staining for tartrate-resistant acid phospha...

FIGURE 1.1.4 Alveolar bone in post-extraction socket at 4 months of healing:...

FIGURE 1.1.5 Cancellous (black asterisk) and cortical bone (blue asterisk) s...

FIGURE 1.1.6 Osteons of the compact bone. Photomicrograph at polarized light...

FIGURE 1.1.7 Particular of a cutting bone. White asterisk: osteocyte; red as...

FIGURE 1.1.8 Bone apposition rate detected by tetracycline double labeling t...

FIGURE 1.1.9 Cutting cones in longitudinal and transversal sections. During...

FIGURE 1.1.10 Howship’s lacunae (red arrow). An osteoclast-like cell secrete...

FIGURE 1.1.11 Healing socket after 10 days of extraction (rat). Immature wov...

FIGURE 1.1.12 Healing socket after 20 days of extraction (rat). The structur...

FIGURE 1.1.13 Alveolar socket healing at 4 months after extraction. The high...

FIGURE 1.1.14 Havers and Volkmann canals (red arrow) in compact/lamellar bon...

FIGURE 1.1.15 Vessels (red asterisks) running in the center of the medullary...

FIGURE 1.1.16 Xenogenic particles at 3 (A) and 9 (B) months of healing in a...

FIGURE 1.1.17 A histological study conducted on humans observed the biocompa...

FIGURE 1.1.18 Newly formed bone in tight contact with a particle of vegetabl...

FIGURE 1.1.19 Bone morphogenetic protein (BMP) promotes osteogenesis by indu...

FIGURE 1.1.20 Bone at the implant interface 10 days after surgery (in a dog...

FIGURE 1.1.21 Bone around an implant thread 7 days after installation (rat)....

FIGURE 1.1.22 Bone around titanium implant threads 90 days after installatio...

FIGURE 1.1.23 Single implant thread. The arrows indicate blood vessels insid...

FIGURE 1.1.24 Two weeks after surgery (dog model). Immature bone along the i...

FIGURE 1.1.25 Intimate and functional contact established by the newly forme...

FIGURE 1.1.26 Osteocytes entrapped in mature bone (red arrows). Interstitial...

FIGURE 1.2.1 Primary intention healing wounds on papilla and attached gingiv...

FIGURE 1.2.2 Same area of vertical incision as in Figure 1.2.1 at 20 days.

FIGURE 1.2.3 Palate heals by secondary intention after harvesting of a free...

FIGURE 1.2.4 (A) Periodontal flap with vertical releasing incision sutured i...

FIGURE 1.2.5 Graphic examples of clinical signs of re-epithelialization (CSR...

Chapter 2

FIGURE 2.1 Bite force of full denture wearers decreases from 200 psi to 50 p...

FIGURE 2.2 Loss of alveolar bone alters the anatomy of the floor of the mout...

FIGURE 2.3 Total loss of the alveolar bone has brought the mental neurovascu...

FIGURE 2.4 Morbid anatomy of an atrophied mandible in a cadaver specimen. No...

FIGURE 2.5 Expansion of the maxillary sinus into the alveolar process with s...

FIGURE 2.6 Anterior and lateral views of the left maxilla. The maxilla is py...

FIGURE 2.7 Facial vestibule. The red line indicates a vestibular incision, w...

FIGURE 2.8 The buccinator muscle attaches above the line of incision. Above...

FIGURE 2.9 Computed tomographic (CT) scan showing all the anatomical feature...

FIGURE 2.10 The infraorbital nerve (red arrow) is sandwiched between the lev...

FIGURE 2.11 (A) Origin of the depressor septi muscle; (B) origin of the supe...

FIGURE 2.12 Maxillary division of the trigeminal nerve as it exits the crani...

FIGURE 2.13 Arterial supply of the maxilla and mandible.

FIGURE 2.14 Venous drainage of the maxilla and mandible.

FIGURE 2.15 Anatomical landmarks of the facial and lingual views of the mand...

FIGURE 2.16 Lingual view of the mandible showing the lingual nerve at the pt...

FIGURE 2.17 The mentalis muscle takes its origin from the side of the mental...

FIGURE 2.18 V3 red (motor) and blue (sensory). The mandibular nerve exits th...

FIGURE 2.19 (A, B) Cone beam computed tomography cross-sectional images of t...

FIGURE 2.20 Coronal cut of the mandible at the second molar region, showing...

Chapter 3

FIGURE 3.1 (A) Periapical radiograph of the right posterior maxilla with ind...

FIGURE 3.2 Panoramic anatomical landmarks: (1) pterygo-maxillary fissure; (2...

FIGURE 3.3 (A) Cropped panoramic image showing vertical bone measurement (of...

FIGURE 3.4 (A) A cropped panoramic of the right posterior mandible with miss...

FIGURE 3.5 CBCT cross-section of the anterior maxilla and mandible showing a...

FIGURE 3.6 (A) Mid-sagittal view CBCT showing the incisive canal located pal...

FIGURE 3.7 (A) Coronal view CBCT showing the location of the canalis sinuosu...

FIGURE 3.8 Mid-sagittal view CBCT showing the anterior nasal spine in the mi...

FIGURE 3.9 (A) Coronal view CBCT showing perforation of the floor of the rig...

FIGURE 3.10 (A) CBCT cross-sections showing atrophy in the anterior maxilla....

FIGURE 3.11 Coronal view CBCT showing paranasal sinuses with a patent osteo-...

FIGURE 3.12 Coronal view CBCT showing dislodgment of the graft into the maxi...

FIGURE 3.13 Sagittal view CBCT showing no sinus reaction in spite of three i...

FIGURE 3.14 (A) Coronal view CBCT showing infection of the left maxillary si...

FIGURE 3.15 (A) Coronal view CBCT showing a large mucous retention pseudocys...

FIGURE 3.16 Coronal view CBCT showing the greater palatine foramen (arrows) ...

FIGURE 3.17 CBCT-generated panoramic section showing the mandibular incisive...

FIGURE 3.18 (A, B) Sagittal view CBCTs of the anterior mandible demonstratin...

FIGURE 3.19 (A) Axial view CBCT showing two superior genial tubercles on eit...

FIGURE 3.20 CBCT-generated panoramic cross-section showing an accessory bran...

FIGURE 3.21 CBCT showing implant interrupting the superior and inferior bord...

FIGURE 3.22 CBCT of the mental foramen on the apical aspect of the mandibula...

FIGURE 3.23 (A) Panoramic radiograph of the right side and (B) CBCT cross-se...

FIGURE 3.24 Bilateral large sublingual salivary gland depressions seen on CB...

FIGURE 3.25 (A) CBCT panoramic of a severely atrophic mandible. (B) Cross-se...

FIGURE 3.26 Axial view CBCT showing metallic streak artifacts that appear as...

FIGURE 3.27 Orienting the sagittal tilt on a CBCT scan. (A) Sagittal view sh...

FIGURE 3.28 (A) CBCT-generated panoramic with incorrect sagittal tilt (corre...

FIGURE 3.29 Cross-sections generated for bone width measurement should be pe...

FIGURE 3.30 CBCT multiplanar reformats showing the trajectory of a planned i...

FIGURE 3.31 The same images as Figure 3.30, but showing the placement of a v...

FIGURE 3.32 Fusion of an intraoral optical scan with the CBCT scan of the sa...

FIGURE 3.33 (A–H) Clinical intra-operative photographs of a surgical guide. ...

FIGURE 3.34 The X-Guide Machine tracks the handpiece in real time during sur...

FIGURE 3.35 A virtual plan on the CBCT scan. The mandibular canal is marked...

FIGURE 3.36 Registration of the drill to the X-Guide system to enable real-t...

FIGURE 3.37 Graphic illustrating the dimensions of drill bit control with si...

FIGURE 3.38 The tracking system indicates that the drill bit tip is correctl...

FIGURE 3.39 The handpiece properly aligned. The yellow arch is depth control...

FIGURE 3.40 The same as Figure 3.39, with the green ring indicating that the...

Chapter 4

FIGURE 4.1 (A) Cone beam computed tomography scan demonstrating a horizontal...

FIGURE 4.2 High lip profiles are more esthetically challenging as the gingiv...

FIGURE 4.3 Moderate lip profiles are less esthetically challenging as the gi...

FIGURE 4.4 Low lip profiles are esthetically neutral. Grafting in these inst...

FIGURE 4.5 The diagnostic wax-up can be duplicated in acrylic resin impregna...

FIGURE 4.6 Examples of fiduciary markers on radiographs. (A) The sphere is o...

FIGURE 4.7 Computed tomography scan with a SimPlant plan for the placement o...

FIGURE 4.8 The dual-scan technique is demonstrated in this figure. The diagn...

FIGURE 4.9 Examples of a plan and final result for a patient requiring full...

FIGURE 4.10 (A–C) Examples of a failing endodontically treated tooth and sub...

FIGURE 4.11 (A, B) Radiograph and clinical photo of a failing endodontically...

FIGURE 4.12 The replacement of congenitally missing lateral incisors after s...

FIGURE 4.13 Maxillary right lateral incisor presents with a gray gingival hu...

FIGURE 4.14 (A–D) Central incisors replaced with dental implants and screw-r...

FIGURE 4.15 Palatal defects are often overlooked. In this case the dental im...

FIGURE 4.16 Extraction and immediate placement of dental implants can preven...

FIGURE 4.17 A 7.0 mm dental implant is used to restore a missing maxillary f...

FIGURE 4.18 A mandibular right second premolar is replaced with a dental imp...

FIGURE 4.19 (A–G) The mandibular left first molar is fractured and not resto...

FIGURE 4.20 (A, B) Pre-operative radiograph. (C) Orthodontic site preparatio...

FIGURE 4.21 (A) Pre-treatment clinical photographs of a failing maxillary de...

FIGURE 4.22 This patient presents with a failing maxillary and mandibular de...

FIGURE 4.23 When all else fails in the maxilla, zygomatic implants are an ap...

Chapter 5

FIGURE 5.1 Guided bone regeneration procedure with a particulate bone grafti...

FIGURE 5.2 Autogenous block bone graft procedure: two symphyseal (chin) bone...

FIGURE 5.3 Collagen membrane can be used to cover the block graft prior to p...

FIGURE 5.4 Large vertical extraosseous bone atrophy can be seen on a cone be...

FIGURE 5.5 Intraosseous post-extraction bone deficiency and sockets in the a...

FIGURE 5.6 Ridge-split expansion procedure: two implants are positioned insi...

FIGURE 5.7 Clinical example of guided bone regeneration technique in the lef...

FIGURE 5.8 Distraction osteogenesis procedure in the posterior mandible (rig...

FIGURE 5.9 Alveolar bone classification by deficiency (ABCD) type 0/I. Clini...

FIGURE 5.10 Alveolar bone classification by deficiency (ABCD) type 0/I. Cone...

FIGURE 5.11 Alveolar bone classification by deficiency (ABCD) type II/I. Cli...

FIGURE 5.12 Alveolar bone classification by deficiency (ABCD) type II/I. Cli...

FIGURE 5.13 Alveolar bone classification by deficiency (ABCD) type II/III. C...

FIGURE 5.14 Alveolar bone classification by deficiency (ABCD) type II/III. C...

Chapter 6

FIGURE 6.1 Flap pattern from vascularity: (A) random pattern; (B) axial patt...

FIGURE 6.2 A clinical case of trapezoidal flap. (A) Flap design and decortic...

FIGURE 6.3 The design of the trapezoidal flap. The base of the flap should h...

FIGURE 6.4 The triangular flap. (A) Vertical incision must be designed consi...

FIGURE 6.5 The incision should be made 3–5 mm away from the bony defect or g...

FIGURE 6.6 Variations of acceptable flap patterns: (A) crestal incisions as...

FIGURE 6.7 A vestibular incision is applied for cases with poor vascularity...

FIGURE 6.8 Reflection of the mucoperiosteum. (A) Flap design. (B) The elevat...

FIGURE 6.9 Tension release incision. (A) The red line shows the place of a r...

FIGURE 6.10 Tension-releasing incision and closure at the site of the alveol...

FIGURE 6.11 Anchoring sutures for periosteum traction after a tension releas...

FIGURE 6.12 Type of sutures: (A) Interrupted suture; (B) continuous suture; ...

FIGURE 6.13 Diagram and intraoral photo of sutures for a crestal incision. (...

FIGURE 6.14 The risks of nerve damage: (A) incisions for edentulous mandible...

FIGURE 6.15 Diagram of an inadequate incision that induces damage to the pal...

FIGURE 6.16 Intraoral photograph of a hematoma followed by swelling inducing...

FIGURE 6.17 Wound dehiscence. (A) Two weeks post-operative from bone graft w...

Chapter 7

FIGURE 7.1 The entire fibula is free and the tourniquet is released with exc...

FIGURE 7.2 Fibula osteocutaneous free flap after three closing wedge osteoto...

FIGURE 7.3 Inset of the fibula osteocutaneous free flap to restore the bilat...

FIGURE 7.4 Clinical photos showing vertical alveolar distraction of the ante...

FIGURE 7.5 The buccal fragment of bone is being subfractured and then slowly...

FIGURE 7.6 Two implants are positioned inside the split ridge according to t...

FIGURE 7.7 Condition after fixation of the osteotomized bone segment moved v...

FIGURE 7.8 Clinical photograph of soft tissue dehiscence following inlay blo...

FIGURE 7.9 Clinical photograph depicting resorption of maxillary tuberosity...

FIGURE 7.10 Panoramic radiograph demonstrating block bone graft for vertical...

FIGURE 7.11 Clinical photograph showing block bone graft for vertical ridge...

FIGURE 7.12 Clinical photograph depicting failed block bone graft fixated wi...

FIGURE 7.13 Clinical photograph showing failed block bone graft in the anter...

FIGURE 7.14 Cone beam computed tomography scan showing failed block bone gra...

FIGURE 7.15 Cortical tenting with 3–4 mm distance.

FIGURE 7.16 Clinical photograph demonstrating disintegration of cortical aut...

FIGURE 7.17 Clinical photograph showing disintegration of cortical autogenou...

FIGURE 7.18 Clinical photograph depicting failure of a connective tissue gra...

FIGURE 7.19 Clinical photograph showing failure of a connective tissue graft...

FIGURE 7.20 Clinical photograph showing failure of a connective tissue graft...

Chapter 8

FIGURE 8.1 The characteristics of normal bone (native bone). Ca, calcium; P,...

FIGURE 8.2 Different types of bone grafts. DFDBA, demineralized freeze-dried...

FIGURE 8.3 The characteristics of allograft bone. Ca, calcium; P, phosphate....

FIGURE 8.4 The characteristics of xenograft bone. Ca, calcium; P, phosphate....

FIGURE 8.5 The characteristics of alloplasts. Ca, calcium; P, phosphate.

Chapter 9

FIGURE 9.1 Initial clinical view, buccal. Note recession on left maxillary f...

FIGURE 9.2 Close-up of clinical view, buccal, left maxillary first premolar....

FIGURE 9.3 Buccal view immediately after extraction.

FIGURE 9.4 Occlusal view immediately after extraction.

FIGURE 9.5 Materials utilized.

FIGURE 9.6 Membrane trimmed and positioned under the periosteum on the bucca...

FIGURE 9.7 Occlusal view, showing the membrane placed under the periosteum o...

FIGURE 9.8 Bone graft material wet with blood, in a conical shape to fit the...

FIGURE 9.9 Occlusal view, graft material placed, and membrane open toward bu...

FIGURE 9.10 Occlusal view, membrane folded over socket entrance, tucked into...

FIGURE 9.11 Soft tissue substitute positioned to seal the socket.

FIGURE 9.12 Soft tissue substitute sutured over the socket with 5-0 Monocryl...

FIGURE 9.13 Clinical aspect 5 months after ridge preservation, at moment of...

FIGURE 9.14 Clinical aspect 3 months after implant placement.

FIGURE 9.15 Final restorations placed.

FIGURE 9.16 Buccal view, showing esthetic imbalance on anterior teeth. Left...

FIGURE 9.17 Occlusal view, before extraction of left maxillary central incis...

FIGURE 9.18 Cone beam computed tomography showing longitudinal fracture of l...

FIGURE 9.19 Occlusal view immediately after minimally traumatic extraction....

FIGURE 9.20 Buccal view immediately after extraction. Note adjacent teeth pr...

FIGURE 9.21 Grafting material wet with blood, ready to be placed.

FIGURE 9.22 Graft material being positioned into the socket.

FIGURE 9.23 Graft material being gently pushed into the socket with the use...

FIGURE 9.24 Occlusal view, graft material positioned and covered with collag...

FIGURE 9.25 Provisional restoration with a pontic prepared in an ovoid shape...

FIGURE 9.26 Clinical aspect, occlusal view, 5 months after grafting, prior t...

FIGURE 9.27 Cone beam computed tomography showing complete healing of graft...

FIGURE 9.28 Connective tissue graft harvested from the tuberosity is sutured...

FIGURE 9.29 Occlusal intraoperative view of implant placement.

FIGURE 9.30 Occlusal view, immediately after implant placement and soft tiss...

FIGURE 9.31 Final restorations, 3 months after implant placement.

Chapter 10

FIGURE 10.1 The three main growth factors that are released from platelet ri...

FIGURE 10.2 Clinical photo of a Bio-PRF centrifuge demonstrating the horizon...

FIGURE 10.3 Illustrations comparing fixed-angle and horizontal centrifuges. ...

FIGURE 10.4 Three centrifugation protocols needed for the production of plat...

FIGURE 10.5 Clinical photo of a fabricated “sticky bone” by using particulat...

FIGURE 10.6 Use of platelet-rich fibrin (PRF) in combination with a bone all...

FIGURE 10.7 Case regenerated using autogenous bone with deproteinized bovine...

FIGURE 10.8 Large guided bone regeneration requiring both lingual and buccal...

FIGURE 10.9 (A) Small Schneiderian membrane perforation during a standard la...

FIGURE 10.10 Lateral sinus floor elevation and platelet-rich fibrin (PRF) me...

FIGURE 10.11 Decision-making flow chart describing the use of platelet-rich...

FIGURE 10.12 Step-by-step clinical demonstration of the production of e-PRF...

FIGURE 10.13 (A, B) Clinical photos of an e-PRF (extended platelet-rich fibr...

FIGURE 10.14 (A) Clinical photo demonstrating maxillary anterior teeth with...

FIGURE 10.15 Custom Bio-Heat trays are available to fabricate custom squares...

FIGURE 10.16 Use of extended platelet-rich fibrin (e-PRF) membranes during a...

FIGURE 10.17 (A) Mid-40-year-old female patient with pronounced Mariotte lin...

Chapter 11

FIGURE 11.1 The membrane has been trimmed and initial fixation of the membra...

FIGURE 11.2 A combination of autogenous bone with allograft and/or xenograft...

FIGURE 11.3 Final fixation of the lingual with fixation screws.

FIGURE 11.4 Flap release has been accomplished and primary closure achieved...

FIGURE 11.5 Representative case of a significant alveolar ridge defect and t...

FIGURE 11.6 Composite graft consisting of autogenous bone and freeze-dried b...

FIGURE 11.7 Particulated composite graft hydrated with platelet-rich plasma....

FIGURE 11.8 The porcine collagen membrane over the bone graft is well adapte...

FIGURE 11.9 The healed guided bone regeneration site after four months of he...

FIGURE 11.10 (A) Healing abutment placed. (B, C) Final radiograph and clinic...

FIGURE 11.11 Radiographic evidence consistent with severe peri-implant bone...

FIGURE 11.12 Exposed crestal aspect of implant showing bone and soft tissue...

FIGURE 11.13 The implant was atraumatically removed, revealing the resulting...

FIGURE 11.14 Freeze-dried bone allograft was used in conjunction with a reso...

FIGURE 11.15 Post-operative healing of the tissue graft.

FIGURE 11.16 Post-operative healing of the newly regenerated osseous defect....

FIGURE 11.17 An implant placed in Site 24 to support a cantilever crown.

FIGURE 11.18 The implant has been uncovered with a healing abutment placed....

FIGURE 11.19 Periapical radiograph taken after one month of loading.

FIGURE 11.20 Final implant restoration and keratinized tissue showing peri-i...

FIGURE 11.21 Periapical radiograph depicting a failing bonded bridge.

FIGURE 11.22 Pre-operative clinical photo of failing bonded bridge.

FIGURE 11.23 Clinical photo showing the buccal ridge defect of the edentulou...

FIGURE 11.24 Clinical photo showing the severely atrophic buccal ridge defec...

FIGURE 11.25 The severe buccal concavity has been grafted with a combination...

FIGURE 11.26 The Cytoplast membrane has been fixated and covered with a BioX...

FIGURE 11.27 Post-operative healing of the ridge defect after 4–5 months.

FIGURE 11.28 Newly regenerated bone showing excellent ridge width and placem...

FIGURE 11.29 Recently placed Astra implant in the newly regenerated alveolar...

FIGURE 11.30 Final restoration was placed following provisionalization of 6–...

FIGURE 11.31 Final periapical radiograph approximately one month post loadin...

FIGURE 11.32 Initial photograph of trauma resulting in avulsion of teeth and...

FIGURE 11.33 Fixation screw securing fractured alveolus.

FIGURE 11.34 Initial bone grafting at time of placement of fixation screw.

FIGURE 11.35 Excellent healing of previously fractured alveolus. Fixation sc...

FIGURE 11.36 Tissue graft completed prior to completing second guided bone r...

FIGURE 11.37 Secondary bone graft placed utilizing a composite graft of auto...

FIGURE 11.38 dPTFE membrane secured on both palatal and buccal aspects.

FIGURE 11.39 A resorbable membrane was added to the 8 and 9 sites to provide...

FIGURE 11.40 Healing after six months.

FIGURE 11.41 Buccal view of guided bone regeneration. Excellent vertical and...

FIGURE 11.42 Implants were uncovered in second-stage procedure. Note adequat...

FIGURE 11.43 Screw-retained provisional restoration was fabricated.

FIGURE 11.44 Screw-retained provisional was placed to aid in soft tissue con...

FIGURE 11.45 Final restoration delivered following four months of provisiona...

FIGURE 11.46 Final radiograph one month following delivery and loading of th...

FIGURE 11.47 Periapical radiograph depicting extensive bone loss of failing...

FIGURE 11.48 Horizontal and vertical ridge defect following removal of faili...

FIGURE 11.49 A dPTFE membrane was fixated on the lingual and a composite gra...

FIGURE 11.50 The membrane was trimmed so as not to impinge on the inferior a...

FIGURE 11.51 Healing of eight months revealed a fully regenerated ridge rega...

FIGURE 11.52 A surgical guide was utilized to place three implants.

FIGURE 11.53 Implants were placed in the first and second premolar and first...

FIGURE 11.54 Individual screw-retained crowns were utilized.

FIGURE 11.55 Periapical radiograph taken following one month of loading.

FIGURE 11.56 Clinical photograph of failing four-unit bridge.

FIGURE 11.57 Buccal ridge defect at sites 29 and 30 with cortical perforatio...

FIGURE 11.58 Composite graft consisting of autogenous bone and freeze-dried...

FIGURE 11.59 Collagen membrane covers composite graft and is secured with se...

FIGURE 11.60 Implants were restored with individual screw-retained crowns.

FIGURE 11.61 Periapical radiograph taken one month after loading.

Chapter 12

FIGURE 12.1 Schematic picture of onlay bone graft for horizontal augmentatio...

FIGURE 12.2 Schematic picture of horizontal bone augmentation using the cort...

FIGURE 12.3 Horizontal bone augmentation using buccal fat pad–derived cells...

FIGURE 12.4 (A) Short vertical incision design in the anterior maxilla for b...

FIGURE 12.5 (A–D) A bilateral cortical autogenous tenting technique in horiz...

FIGURE 12.6 (A–C) Bilateral cortical autogenous tenting with chin block in h...

FIGURE 12.7 (A) A horizontal defect in the anterior maxilla with a length of...

FIGURE 12.8 (A) An extensive defect in the anterior maxilla (>6 cm). (B) Lat...

Chapter 13

FIGURE 13.1 Extremely reduced remaining alveolar bone that precludes ridge e...

FIGURE 13.2 Extremely angulated alveolar ridges.

FIGURE 13.3 Severe skeletal discrepancy due to alveolar bone resorption.

FIGURE 13.4 Elimination of the flange of the removable prosthesis for an imp...

FIGURE 13.5 Allogenic block graft helps to provide bone bed for appropriate...

FIGURE 13.6 Minimal marrow space in atrophic ridge.

FIGURE 13.7 Pre-operative view of missing maxillary right and left lateral i...

FIGURE 13.8 Pre-operative radiography. The cone beam computed tomography ima...

FIGURE 13.9 (A) Illustration of a labial defect in the maxillary anterior re...

FIGURE 13.10 Evaluation of recipient site prior to preparation of the bed. (...

FIGURE 13.11 (A) Periosteal release incision in advance of block placement. ...

FIGURE 13.12 (A) Decortication to create definitive borders of mortise prepa...

FIGURE 13.13 Contouring of the allogenic block graft to fit into the defect...

FIGURE 13.14 Graft stabilized and implant screw tightened. Fixation of the b...

FIGURE 13.15 (A) Preparation of platelet-rich fibrin. (B) Scoring of periost...

FIGURE 13.16 (A) Coverage of the allogenic block with platelet-rich fibrin. ...

FIGURE 13.17 Post-operative cone beam computed tomography revealing augmenta...

FIGURE 13.18 (A) Post-operative increase in horizontal alveolar width can be...

FIGURE 13.19 Post-operative implant placement within adequate bone augmented...

FIGURE 13.20 Sequential radiographs before and after rehabilitation. (A) Bef...

FIGURE 13.21 (A–C) Completion of rehabilitation and restoration of smile.

FIGURE 13.22 Pre-operative orthopantograph.

FIGURE 13.23 Pre-operative cone beam computed tomography scan.

FIGURE 13.24 Clinical evaluation of the patient planned for anterior sextant...

FIGURE 13.25 Palatal to mid-crest incision and reflection of full-thickness...

FIGURE 13.26 Recipient bed preparation and adaptation of the large segment o...

FIGURE 13.27 Fixation of the allogenic block graft with titanium screws. (A)...

FIGURE 13.28 (A) Post-operative outcome after four months of augmentation su...

FIGURE 13.29 Comparison of pre-operative and post-operative clinical present...

FIGURE 13.30 (A, B) Removal of the titanium screws from the grafted site aft...

FIGURE 13.31 Comparison of ridge presentation before and after allogenic blo...

FIGURE 13.32 (A, B) Ideal bone contours created by the allogenic graft ensur...

FIGURE 13.33 Harvesting a core biopsy for histomorphometric study. (A) Harve...

FIGURE 13.34 Histomorphometric analysis revealing almost complete bone turno...

FIGURE 13.35 Histomorphometric analysis revealing evidence of vital osteocyt...

FIGURE 13.36 Implant placement by osseodensification. (A) Use of parallel pi...

FIGURE 13.37 Pre-operative orthopantograph.

FIGURE 13.38 Pre-operative cone beam computed tomography scan.

FIGURE 13.39 (A) Clinical evaluation of the patient planned for posterior ho...

FIGURE 13.40 Incision is made lingual to mid-crest and full-thickness flap i...

FIGURE 13.41 (A) Illustration of reflection of full-thickness flap. (B) Peri...

FIGURE 13.42 (A) Recipient bed preparation and decortication. (B) Definitive...

FIGURE 13.43 (A) Hydrated graft is dispensed into a bowl. (B) Block graft so...

FIGURE 13.44 (A) Illustration of fixation of the allogenic block graft with...

FIGURE 13.45 Clinical evaluation of horizontal augmentation. The increase in...

FIGURE 13.46 (A, B) Radiographic evaluation of horizontal augmentation can b...

FIGURE 13.47 (A) Harvesting a core of graft for histomorphometric study. (B)...

FIGURE 13.48 (A) Gross view of core of grafted site collected by trephine bu...

FIGURE 13.49 The grafted site shows vital bone (with osteocytes and osteobla...

FIGURE 13.50 Composition of the specimen studied.

FIGURE 13.51 (A) Osseodensification and restoratively driven implant placeme...

FIGURE 13.52 Comparison of pre-operative and post-operative changes in bone...

FIGURE 13.53 (A) Radiographic confirmation of the implant placed. (B) The im...

FIGURE 13.54 (A) Completion of prosthetic treatment. (B) Radiographic verifi...

Chapters 14.1 to 14.6

FIGURE 14.1.1 Intraoral photograph of a moderate horizontal alveolar bone lo...

FIGURE 14.1.2 Panoramic radiograph of a moderate horizontal alveolar bone lo...

FIGURE 14.1.3 Intraoral photograph of a volumetric bone loss with an alveola...

FIGURE 14.1.4 Panoramic radiograph of a volumetric bone loss with an alveola...

FIGURE 14.1.5 Cone beam computed tomography scan (transaxial slice) of an id...

FIGURE 14.1.6 Cone beam computed tomography scan (transaxial slice) of a com...

FIGURE 14.1.7 Intraoral view of horizontally deficient alveolar ridge in the...

FIGURE 14.1.8 Intraoral view of horizontally deficient alveolar ridge in the...

FIGURE 14.1.9 Intraoral photograph of the collapsed alveolar ridge: digital...

FIGURE 14.1.10 Instrumentation: calipers and gauges that can help to measure...

FIGURE 14.1.11 Cross-sectional (transaxial) slices of cone beam computed tom...

FIGURE 14.1.12 A cone beam computed tomography scan, taken pre-operatively a...

FIGURE 14.1.13 Diagnostic model as part of a pre-operative diagnostic work-u...

FIGURE 14.1.14 A surgical stent as part of a pre-operative diagnostic work-u...

FIGURE 14.1.15 Example of surgical instrumentation for the ridge-split expan...

FIGURE 14.2.1 Illustration of a vascularized hard–soft tissue (osteoperioste...

FIGURE 14.2.2 Illustration of a vascularized hard–soft tissue (osteoperioste...

FIGURE 14.2.3 Intraoperative view of the ridge preservation procedure: refle...

FIGURE 14.2.4 Particular graft was placed into extraction sockets....

FIGURE 14.2.5 Bone graft was covered with resorbable CollaTape membrane, and...

FIGURE 14.2.6 Intraoperative view of the ridge-split expansion procedure: su...

FIGURE 14.2.7 Interpositional grafting: alveolar gap is filled with a partic...

FIGURE 14.2.8 Healing by secondary intention that is recommended in many rid...

FIGURE 14.2.9 Healing by secondary intention: 2.5 months after the surgery. ...

FIGURE 14.2.10 Intraoperative photograph of maxillary book osteo-periosteal...

FIGURE 14.2.11 Intraoperative photograph of maxillary island osteoperiosteal...

FIGURE 14.3.1 Schematic illustration of a cross-section of mandibular bone d...

FIGURE 14.3.2 Illustration of four corticotomies at the initial (preparatory...

FIGURE 14.3.3 Clinical photograph of four corticotomies at the initial (prep...

FIGURE 14.3.4 A single edentulous area with a width-deficient alveolar ridge...

FIGURE 14.3.5 A full edentulous arch with horizontal width deficiency that m...

FIGURE 14.3.6 Intraoperative photograph of two vertical corticotomies connec...

FIGURE 14.3.7 Stage 2 of the mandibular ridge-split expansion procedure thro...

FIGURE 14.3.8 The buccal fragment of bone is displaced laterally with sharp...

FIGURE 14.3.9 Example of a surgical tray with instruments for the ridge-spli...

FIGURE 14.3.10 Intraoperative view of the bone grafting step of a ridge-spli...

FIGURE 14.3.11 Particulate graft is covered with the protective membrane of...

FIGURE 14.3.12 Clinical view of a self-tapping mini-screw that can be used t...

FIGURE 14.3.13 Clinical photograph of the alveolar ridge at the implant stag...

FIGURE 14.3.14 Intraoperative photograph of a case report demonstrating a th...

FIGURE 14.3.15 Intraoperative photograph of a case report demonstrating a th...

FIGURE 14.3.16 Intraoperative photograph of a case report showing subfractur...

FIGURE 14.3.17 Intraoperative photograph of a case report showing interposit...

FIGURE 14.3.18 Clinical view of the implant stage 2, 6 months after the surg...

FIGURE 14.3.19 Clinical photograph of the restorative stage demonstrating th...

FIGURE 14.3.20 Clinical panoramic radiograph of the restorative stage demons...

FIGURE 14.4.1 Illustration of a maxillary single-stage ridge-split expansion...

FIGURE 14.4.2 Intraoperative photograph demonstrating slow and careful expan...

FIGURE 14.4.3 Intraoperative view of the displaced maxillary bone that requi...

FIGURE 14.4.4 Intraoperative view of the displaced maxillary bone that requi...

FIGURE 14.4.5 The ridge-split expansion procedure at its completion: split a...

FIGURE 14.4.6 Panoramic radiograph demonstrating missing teeth (molars and p...

FIGURE 14.4.7 Intraoperative photograph demonstrating careful division (spli...

FIGURE 14.4.8 Intraoperative photograph demonstrating placement of two paral...

FIGURE 14.4.9 Intraoperative photographs demonstrating placement of two impl...

FIGURE 14.4.10 Intraoperative photographs demonstrating placement of two imp...

FIGURE 14.4.11 Intraoperative photograph demonstrating primary closure after...

FIGURE 14.4.12 View of the implant stage 2 that was done nine months after t...

FIGURE 14.4.13 Panoramic radiograph of completion of the restorative stage: ...

FIGURE 14.4.14 Intraoral photograph of completion of the restorative stage: ...

FIGURE 14.5.1 Clinical photograph of a ridge-split expansion procedure at th...

FIGURE 14.5.2 Clinical photograph of a ridge-split expansion procedure at th...

FIGURE 14.5.3 Clinical photograph of the implant placement stage, which is d...

FIGURE 14.5.4 Clinical photograph of the placed implant in the expanded alve...

FIGURE 14.5.5 Clinical photograph of ab open-flap alveolar split with immedi...

FIGURE 14.5.6 Clinical view of the crest-control bone splitting device inser...

FIGURE 14.5.7 Clinical view of an immediate implant placement into the expan...

FIGURE 14.5.8 Clinical photograph of a single edentulous space in the area o...

FIGURE 14.5.9 Panoramic radiograph of the case: missing lateral incisor.

FIGURE 14.5.10 Cone beam computed tomography radiograph showing moderate hor...

FIGURE 14.5.11 Diagnostic model confirming the diagnosis of horizontal alveo...

FIGURE 14.5.12 Intraoperative photographs of the initial stage of the ridge-...

FIGURE 14.5.13 Intraoperative photograph of the initial stage of the ridge-s...

FIGURE 14.5.14 Intraoperative photograph of the ridge split in progress util...

FIGURE 14.5.15 Intraoperative photograph of the ridge split in progress util...

FIGURE 14.5.16 Clinical view of the implant osteotomy after expansion of the...

FIGURE 14.5.17 Intraoperative views of a dental implant that was prepared to...

FIGURE 14.5.18 Intraoperative views of a dental implant that was placed into...

FIGURE 14.5.19 Intraoperative view of a dental implant that was placed into...

FIGURE 14.5.20 Periapical radiograph of the successfully restored implant 6 ...

FIGURE 14.6.1 Clinical photograph showing severe width deficiency of the alv...

FIGURE 14.6.2 Cone beam computed tomography radiograph showing severe width...

FIGURE 14.6.3 Clinical photograph demonstrating complication that resulted f...

FIGURE 14.6.4 Cone beam computed tomography radiograph demonstrating a compl...

FIGURE 14.6.5 Intraoperative photograph of a complication of the ridge-split...

FIGURE 14.6.6 Intraoperative photograph of a complication of the ridge-split...

FIGURE 14.6.7 A complication of the ridge-split expansion procedure when the...

FIGURE 14.6.8 Clinical photograph of a post-operative complication of the ri...

FIGURE 14.6.9 Cone beam computed tomography radiograph showing a wide diamet...

FIGURE 14.6.10 Clinical photograph of a buccal plate that was too thin at th...

FIGURE 14.6.11 Treatment of complication of implant thread exposure with del...

Chapter 15

FIGURE 15.1 Note damaged vessel during osteotomy using a rotary bur. While c...

FIGURE 15.2 Rotary disk.

FIGURE 15.3 Note severe damage to oral mucosa during osteotomy in ridge spli...

FIGURE 15.4 Micro-saw.

FIGURE 15.5 Note damage on lower lip due to improper use of micro-saw.

FIGURE 15.6 Pre-operative computed tomography indicating 1–3 mm of bone widt...

FIGURE 15.7 Intraoral image indicating very narrow edentulous alveolar ridge...

FIGURE 15.8 Crestal osteotomy was done without perforating the buccal concav...

FIGURE 15.9 Note expanded ridge after implant placement.

FIGURE 15.10 Xenograft (Algipore) mixed with platelet-rich plasma was grafte...

FIGURE 15.11 Exposure after 6 months of healing revealed favorable ridge aug...

FIGURE 15.12 A periapical radiograph after cementation of a final restoratio...

FIGURE 15.13 A periapical radiograph after 11 years in function. Slight marg...

FIGURE 15.14 Saw tip with cutting blade on all sides (S-Saw, BukBu Dental, D...

FIGURE 15.15 Intraoral image indicating 2–3 mm of bone width. Note the bucca...

FIGURE 15.16 Ridge splitting using a saw insert. A saw insert allows fast os...

FIGURE 15.17 Note the expanded ridge after placing an implant in the bony en...

FIGURE 15.18 Osteotomes of variable diameters.

FIGURE 15.19 Mono-beveled chisels of various thicknesses.

FIGURE 15.20 A rotary expander not only to expand the split ridge, but to im...

FIGURE 15.21 Ridge expansion using a rotary expander in forward rotation at...

FIGURE 15.22 Expanded ridge using an osseodensification bur in reverse mode...

FIGURE 15.23 Note the precise crestal and vertical osteotomies prepared with...

FIGURE 15.24 A ridge expander was advanced in a forward direction at 50 rpm....

FIGURE 15.25 Note the expanded ridge after placing implants in the bony enve...

FIGURE 15.26 Bone graft over expanded ridge.

FIGURE 15.27 Concentrated growth factor membrane was used to cover the bone...

FIGURE 15.28 A postoperative periapical radiograph.

FIGURE 15.29 An intraoral image indicating favorable ridge augmentation afte...

FIGURE 15.30 An intraoral image after 10 years in function.

FIGURE 15.31 A periapical radiograph indicating stability of marginal bone a...

FIGURE 15.32 Note the 2 mm wide alveolar crest.

FIGURE 15.33 Crestal osteotomy and vertical osteotomies were prepared with a...

FIGURE 15.34 Careful expansion of the buccal plate was performed when expand...

FIGURE 15.35 Note the expanded ridge after placement of implants.

FIGURE 15.36 Intraoral image showing approximately 2 mm expansion in the occ...

FIGURE 15.37 Sticky tooth bone was grafted on the expanded ridge.

FIGURE 15.38 A collagen barrier was placed on top of the bone graft.

FIGURE 15.39 A postoperative radiograph.

FIGURE 15.40 Exposure showed favorable ridge augmentation after 5 months of...

FIGURE 15.41 An intraoral image after the delivery of the final restoration....

FIGURE 15.42 A plain radiograph indicating stable marginal bone after 2 year...

FIGURE 15.43 An intraoral image indicating a very thin alveolar crest.

FIGURE 15.44 Complete rectangular osteotomies were prepared to expand the bu...

FIGURE 15.45 The buccal segment was fractured and expanded to place a bone g...

FIGURE 15.46 Alloplast mixed with whole blood was grafted over the mobile bu...

FIGURE 15.47 Implants were placed after 5 months of healing. Note the widene...

FIGURE 15.48 A panoramic radiograph indication stability of crestal bone aro...

FIGURE 15.49 Note the narrow alveolar crest and thick basal bone.

FIGURE 15.50 Following rectangular osteotomies using an Er:YAG laser in the...

FIGURE 15.51 The ridge was re-exposed after 3 weeks of healing. The buccal s...

FIGURE 15.52 Implants were placed after expanding the ridge with a chisel.

FIGURE 15.53 Allograft mixed with whole blood was grafted on the expanded ri...

FIGURE 15.54 A panoramic radiograph after 7 years in function.

FIGURE 15.55 Note the fractured buccal segment after implant placement. Stab...

FIGURE 15.56 The fractured segment was stabilized with sticky bovine bone.

FIGURE 15.57 (A) Postoperative radiograph. (B) Periapical radiograph indicat...

Chapter 16

FIGURE 16.1 Book flap (Jensen): clinical photograph of the hinged modificati...

FIGURE 16.2 Book flap (Jensen): schematic illustration of the hinged modific...

FIGURE 16.3 Island flap (Jensen): clinical photograph of the displaced (isla...

FIGURE 16.4 Island flap (Jensen): schematic illustration of the displaced (i...

FIGURE 16.5 An osteotome crestal sinus floor elevation technique.

FIGURE 16.6 Radiographic image of a transcrestally elevated sinus floor on a...

FIGURE 16.7 Widening of the ridge by alveolar split for horizontal bone augm...

FIGURE 16.8 Vertical bone expansion by transcrestal sinus intrusion for imme...

FIGURE 16.9 Pre-operative clinical photograph of failing first and second mo...

FIGURE 16.10 Pre-operative radiograph of failing first and second molars. Wi...

FIGURE 16.11 Immediate post-extraction intraoral photograph. With permission...

FIGURE 16.12 Fracture of the buccal segment of both sockets and its facial d...

FIGURE 16.13 Fracture of the buccal segment of both sockets and its facial d...

FIGURE 16.14 Fracture of the buccal segment of both sockets and its facial d...

FIGURE 16.15 Sockets of the first and second molars after the ridge-widening...

FIGURE 16.16 Sinus osteotomes were used for the trans-socket sinus elevation...

FIGURE 16.17 Sinus osteotomes were used for the crestal sinus intrusion. Wit...

FIGURE 16.18 Particulate bone grafting material was placed into the expanded...

FIGURE 16.19 A resorbable membrane was placed to isolate and protect the gra...

FIGURE 16.20 Pre-operative radiograph demonstrating bone and sinus dimension...

FIGURE 16.21 Intraoperative view of the edentulous first molar area at the i...

FIGURE 16.22 Intraoperative view of final osteotome for expansion and floor...

FIGURE 16.23 Intraoperative view of the first molar implant placed at the co...

FIGURE 16.24 Immediate post-operative result demonstrating use of a mesially...

FIGURE 16.25 Post-operative cone beam computed tomography of the first molar...

FIGURE 16.26 The 2-year post-restoration clinical photograph demonstrating e...

FIGURE 16.27 The 2-year post-restoration radiograph showing excellent bone l...

Chapter 17

FIGURE 17.1 (A) bilateral edentulism in the premolar and molar area of the m...

FIGURE 17.2 (A) Bone harvesting area from the ramus and molar area of the ma...

FIGURE 17.3 (A) Bone harvesting area from the mental symphysis. (B–D) With t...

FIGURE 17.4 (A) Bone harvesting area from the anterior iliac crest. (B) A 2 ...

FIGURE 17.5 (A) Bone harvesting area from the parietal calvarium. (B) Access...

FIGURE 17.6 (A–C) Initial clinical situation of a horizontally and verticall...

FIGURE 17.7 Flowchart summarizing the different phases of rehabilitation by...

FIGURE 17.8 (A, B) Initial situation showing severe vertical deficit of the...

FIGURE 17.9 (A) Initial situation showing vertical and horizontal deficit of...

Chapter 18

FIGURE 18.1 (A) Class A: two-wall defect; Class B: one-wall defect; Class C:...

FIGURE 18.2 Recipient site analysis in vertical defect according to the Loca...

FIGURE 18.3 Lateral ramus cortical plate. (A) Up to 3 cm could be harvested....

FIGURE 18.4 (A) Drawing an osteotomy line in the symphysis area. Pay attenti...

FIGURE 18.5 (A) Harvesting anterior palate block graft. (B) Graft fixation w...

FIGURE 18.6 (A) Tubero-alveolar block harvesting. (B) Micro-screw fixation o...

FIGURE 18.7 (A) Anatomical landmark for harvesting posterior iliac bone. (B–...

FIGURE 18.8 (A–D) Anatomical landmarks and harvesting technique for anterior...

FIGURE 18.9 (A–C) Anatomical landmark and cortical block harvesting techniqu...

FIGURE 18.10 (A) Onlay bone grafting with lateral ramus cortical plate. (B) ...

FIGURE 18.11 Schematic drawing presenting the principle of the cortical auto...

FIGURE 18.12 Cortical autogenous tenting (CAT) in the posterior mandible “C”...

FIGURE 18.13 (A) Bilateral cortical autogenous tenting (CAT) in the posterio...

FIGURE 18.14 Simultaneous implant placement with cortical autogenous tenting...

FIGURE 18.15 (A) Trapezoid osteotomy for posterior mandible augmentation. (B...

FIGURE 18.16 (A) Vertical defect type “C” in posterior mandible. (B) Nerve e...

FIGURE 18.17 Pedicle segmental rotation technique in vertical augmentation o...

Chapter 19

FIGURE 19.1 (A) Vertically deficient maxilla approached via vestibular incis...

FIGURE 19.2 Pre-operative panoramic image showing impacted tooth in left sin...

FIGURE 19.3 (A) Pre-operative lateral view (intraoral photograph). (B) Pre-o...

FIGURE 19.4 (A) Intraoperative photograph showing curved lateral osteotomy o...

FIGURE 19.5 (A) Intraoperative photograph depicting a segment of bone that w...

FIGURE 19.6 Intraoperative photograph of the wound closure.

FIGURE 19.7 Cross-sectional (coronal) cone beam computed tomography slices o...

FIGURE 19.8 Intraoperative photograph of removal of hardware and exposure of...

FIGURE 19.9 Intraoperative photograph demonstrating placement of three endos...

FIGURE 19.10 Intraoperative photograph of secondary buccal grafting with xen...

FIGURE 19.11 Post-operative periapical radiographs of placed dental implants...

FIGURE 19.12 Periapical radiograph indicating a final restoration (three-uni...

FIGURE 19.13 The indication for vertical osteotomy of the posterior mandible...

FIGURE 19.14 A smile-shaped osteotomy is used to minimize proximity to the n...

FIGURE 19.15 Alveolar restoration vertically to the alveolar plane allows fo...

FIGURE 19.16 An atrophic posterior mandible with a vertical loss of about 10...

FIGURE 19.17 The smile osteotomy made below unreflected mucosa to allow vert...

FIGURE 19.18 Elevation of the segment is easily done, but care must be taken...

FIGURE 19.19 Interpositional grafting is done with a small block graft harve...

FIGURE 19.20 The interpositional graft and later placement of an implant, he...

Chapter 20

FIGURE 20.1 (A) MicroSaw devices. (B) Bone block harvesting from the mandibu...

FIGURE 20.2 (A) Fracture of an implant. (B) A bony lid is cut with the Micro...

FIGURE 20.3 (A) The trephine kit. (B) Two-piece trephine. (C) Pre-trephines...

FIGURE 20.4 (A) Bony defect in the area of the mandibular first molar. (B) B...

FIGURE 20.5 (A) Clinical situation after failed grafting with allograft bloc...

FIGURE 20.6 (A) Severe bony defect in the anterior left maxilla. (B) Clinica...

FIGURE 20.7 (A) Large three-dimensional bony defect in the left posterior ma...

FIGURE 20.8 (A) Three-dimensional grafting of the right posterior mandible t...

Chapter 21

FIGURE 21.1 Cone beam computed tomography exhibiting an atrophic posterior m...

FIGURE 21.2 Sections of the cone beam computed tomography in Figure 21.1 dem...

FIGURE 21.3 Clinical photograph demonstrating the vestibular incision perfor...

FIGURE 21.4 The trapezoid osteotomy performed in alveolar distraction osteog...

FIGURE 21.5 Photograph of an alveolar distraction osteogenesis device connec...

FIGURE 21.6 Using two devices for a large span. (A) Clinical photo of two al...

FIGURE 21.7 Suturing of the surgical incision in the maxillary vestibulum us...

FIGURE 21.8 Activation phase. (A) Illustration of the activation process of...

FIGURE 21.9 Panoramic radiograph following maxillary alveolar distraction os...

FIGURE 21.10 Clinical photograph exhibiting exposure of the fixation plates...

FIGURE 21.11 Clinical photograph showing elastics and orthodontic devices us...

FIGURE 21.12 Panoramic radiographs performed following device fixation and p...

FIGURE 21.13 Panoramic radiograph performed following dental implant placeme...

FIGURE 21.14 Three-dimensional reconstruction of cone beam computed tomograp...

FIGURE 21.15 Panoramic radiographs exhibiting a case of deficient posterior...

FIGURE 21.16 Panoramic radiograph exhibiting the application of a large alve...

FIGURE 21.17 Onlay bone graft prior to alveolar distraction osteogenesis (AD...

FIGURE 21.18 Case presentation of a 22-year-old male with severe deficiency...

FIGURE 21.19 Intraoperative clinical photographs of the patient presented in...

FIGURE 21.20 Panoramic radiographs and clinical photographs prior to and pos...

FIGURE 21.21 Pre and post treatment of the case described in Figure 21.20. (...

FIGURE 21.22 Clinical and radiographic outcomes following the treatment of t...

FIGURE 21.23 Profile photographs of the patient described in Figure 21.22. (...

FIGURE 21.24 Case presentation of a 25-year-old male with severe deficiency...

FIGURE 21.25 Following activation of the alveolar distraction osteogenesis (...

FIGURE 21.26 Dental implant placement and prosthetic rehabilitation of the p...

Chapter 22

FIGURE 22.1 Pre-extractive orthodontic extrusion improves the future implant...

FIGURE 22.2 Osseointegration is obtained.

FIGURE 22.3 Esthetic failure due to inadequate hard and soft tissue.

FIGURE 22.4 Orthodontic role to improve implant sites: (A) soft tissue profi...

FIGURE 22.5 Treatment protocol.

FIGURE 22.6 Diagnosis of the defect.

FIGURE 22.7 Endodontic treatment.

FIGURE 22.8 Periodontal therapy.

FIGURE 22.9 Orthodontic application.

FIGURE 22.10 2 weeks of periodontal and occlusal monitoring.

FIGURE 22.11 2 months of stabilization.

FIGURE 22.12 Tooth extraction.

FIGURE 22.13 Immediate implant placement (flapless if possible).

FIGURE 22.14 Immediate temporary crown placement.

FIGURE 22.15 Extrusion must occur along the tooth’s long axis.

FIGURE 22.16 Pre-treatment x-rays.

FIGURE 22.17 Post-orthodontics x-rays.

FIGURE 22.18 Post-treatment x-rays.

FIGURE 22.19 Orthodontic guided bone regenerative effect in inter-radicular...

FIGURE 22.20 Pre-treatment clinical situation.

FIGURE 22.21 Probing >10 mm and the buccal bone is completely missing up to...

FIGURE 22.22 The extrusive movement of the left central incisor fills the bo...

FIGURE 22.23 The movement is completed with a buccal root torque that fills...

FIGURE 22.24 Computed tomography scan slice shows the amount of newly formed...

FIGURE 22.25 Post-extractive alveolus is almost non-existent: ideal for impl...

FIGURE 22.26 Immediate temporary emergence profile is achieved out of the mo...

FIGURE 22.27 Temporary crown is inserted the same day as implant placement (...

FIGURE 22.28 Final crown placement.

FIGURE 22.29 The first orthodontic phase consists of extrusive movement. The...

FIGURE 22.30 The second phase consists of buccal root torque.

FIGURE 22.31 Horizontal tooth movement used to close post-extraction spaces...

FIGURE 22.32 A thin alveolar ridge represents an unfavorable area for implan...

FIGURE 22.33 Clinical case showing deciduous central lower incisors in an ad...

FIGURE 22.34 Teeth are moved into the gap carrying the surrounding hard and...

FIGURE 22.35 An ideal implant site is created on the opposite side of the mo...

FIGURE 22.36 The teeth are moved mesially through the alveolar process, movi...

FIGURE 22.37 The presence of the papilla depends on the distance between the...

FIGURE 22.38 In the single-implant case scenario, the presence of a regular...

FIGURE 22.39 A bodily tooth movement is performed by placing a stainless ste...

FIGURE 22.40 The final restoration consists of two ceramo-zirconia crowns on...

FIGURE 22.41 Bone regenerated by a combination of horizontal and vertical mo...

FIGURE 22.42 Initial severe esthetic defect.

FIGURE 22.43 Severe bone loss around upper left central incisor, canine, and...

FIGURE 22.44 The cuspid was considered hopeless, but a crown lengthening was...

FIGURE 22.45 Initial alignment and extrusion using a round 0.016 in. HANT ar...

FIGURE 22.46 Initial tooth extrusion of the cuspid separated from the pontic...

FIGURE 22.47 Orthodontic extrusion generates new bone tissue along the verti...

FIGURE 22.48 The mesial bone peak of the upper left cuspid is moved more cor...

FIGURE 22.49 A compressed nickel-titanium (NiTi SE) coil spring placed on th...

FIGURE 22.50 Immediate insertion of three implants. A roll flap improves the...

FIGURE 22.51 After 6 months tissue conditioning is complete.

FIGURE 22.52 The final restoration consists of a four-unit ceramo-metal crow...

FIGURE 22.53 Post orthodontics: both soft and hard tissue levels are adequat...

FIGURE 22.54 Tissue levels are stable over time (9-year follow-up).

FIGURE 22.55 Contraindications to extrusive movement: (A) occlusal traumatic...

FIGURE 22.56 The main mechanical advantages of an orthodontically developed...

FIGURE 22.57 The left central incisor is not restorable and must be extracte...

FIGURE 22.58 Osseointegration is complete and platform switching helps in ma...

FIGURE 22.59 Final restoration: a ceramo-zirconia crown is cemented on the z...

FIGURE 22.60 The result is stable over time. Gingival and bone level are the...

Chapter 23

FIGURE 23.1 Two 12 mm long micro-screws were placed on the recipient site. N...

FIGURE 23.2 Grafting of mineral allograft soaked with antibiotics.

FIGURE 23.3 The uncovering procedure revealed favorable three-dimensional ri...

FIGURE 23.4 Intraoral image after 11 years in function.

FIGURE 23.5 A periapical radiogram after 11 years in function reveals favora...

FIGURE 23.6 Intraoral image before extraction of hopeless teeth and implant-...

FIGURE 23.7 Pre-operative panoramic view after extraction of all teeth: vert...

FIGURE 23.8 Periapical radiograph revealed severe vertical deficiency of the...

FIGURE 23.9 Note the severe vertical defect after elevation of a full-thickn...

FIGURE 23.10 Note the 6 mm high exposure of the implant surface placed on th...

FIGURE 23.11 Tent-pole healing abutments were placed on each implant platfor...

FIGURE 23.12 Sticky demineralized osteoinductive tooth bone graft was placed...

FIGURE 23.13 Post-operative panoramic image after implant placement. Three m...

FIGURE 23.14 Note the bone graft placed over the implant platform.

FIGURE 23.15 Intraoral view indicating favorable ridge augmentation after 6 ...

FIGURE 23.16 Periapical radiograph showing favorable ridge augmentation over...

FIGURE 23.17 Intraoral image after delivery of upper and lower implant-suppo...

FIGURE 23.18 Panoramic image after delivery of zirconia-based fixed restorat...

FIGURE 23.19 A plain radiograph indicating stable marginal bone over the imp...

FIGURE 23.20 (A) SANTA-1 has a 1 mm cuff height and is indicated for horizon...

FIGURE 23.21 The implant is placed 1 mm deep to the lingual crest.

FIGURE 23.22 SANTA-1 is placed on the implant platform and tightened to 10 N...

FIGURE 23.23 Biomaterials are placed on the bony defect around the implant a...

FIGURE 23.24 Pre-operative intraoral image showing horizontal alveolar defic...

FIGURE 23.25 Occlusal view indicating significant horizonal bone resorption....

FIGURE 23.26 Note the severe bony defect.

FIGURE 23.27 Note the large exposure of the implant surface.

FIGURE 23.28 Placement of SANTA-1 abutment to allow over-grafting of the bon...

FIGURE 23.29 Grafting of biomaterial on the defect.

FIGURE 23.30 Concentrated growth factor membranes placed over the bone graft...

FIGURE 23.31 Post-operative periapical radiograph.

FIGURE 23.32 (A) Post-operative cone beam computed tomography (CBCT) image i...

FIGURE 23.33 Intraoral image showing favorable ridge augmentation after 11 w...

FIGURE 23.34 Note the well-maintained bone graft around SANTA-1 and the impl...

FIGURE 23.35 Intraoral image in 1-year loading revealed esthetic outcomes.

FIGURE 23.36 Periapical radiograph indicting stable bone graft over the impl...

FIGURE 23.37 The implant is placed 2 mm subcrestally to the proximal bony cr...

FIGURE 23.38 Placement of SANTA-2 on the implant platform to house the bone...

FIGURE 23.39 Over-grafting of biomaterial over the implant platform.

FIGURE 23.40 Note the suppuration and mucosal swelling due to improper heali...

FIGURE 23.41 Piezoelectric curettage was done to remove necrotic bone and in...

FIGURE 23.42 Concentrated growth factor blocks were placed in the defect to...

FIGURE 23.43 Panoramic radiograph indicating severe three-dimensional ridge...

FIGURE 23.44 Note the significant bony defect after elevation of a full-thic...

FIGURE 23.45 Harvesting autogenous bone chips from the retromolar area.

FIGURE 23.46 Note 5–8 mm exposure of implants. SANTA-2 abutments were connec...

FIGURE 23.47 Grafting of sticky autogenous bone graft along the exposed impl...

FIGURE 23.48 Grafting of sticky porcine bone as a space maintainer.

FIGURE 23.49 A collagen barrier was placed over the bone graft without membr...

FIGURE 23.50 Tension-free primary closure.

FIGURE 23.51 Post-operative periapical radiograph indicating implants and bo...

FIGURE 23.52 (A) Post-operative cone beam computed tomography (CBCT) image. ...

FIGURE 23.53 Periapical radiograph after the uncovering procedure. Note the...

FIGURE 23.54 To widen the zone of attached keratinized gingiva, a free gingi...

FIGURE 23.55 Free gingival graft was stabilized with tissue cyanoacrylate (n...

FIGURE 23.56 Periapical radiograph after completion of final restoration.

Chapter 24

FIGURE 24.1 (A, B) Classic indication for sinus elevation moderate atrophy i...

FIGURE 24.2 (A–C) In clinical cases with vertical and/or horizontal bone atr...

FIGURE 24.3 (A, B) Micro-antrostomy is performed to find the sinus membrane,...

FIGURE 24.4 (A) The low window sinus lift antrostomy. The lower osteotomy li...

FIGURE 24.5 (A) Pre-operative cone beam computed tomography (CBCT) examinati...

FIGURE 24.6 (A) Post-operative x-ray showing maxillary sinus graft integrati...

FIGURE 24.7 (A) The surgical procedure starts by identifying where to place...

Chapter 25

FIGURE 25.1 General pictorial depiction of the Summers osteotome transcresta...

FIGURE 25.2 Clinical case depicting the transcrestal sinus floor elevation t...

FIGURE 25.3 General pictorial depiction of the Michigan reamer transcrestal...

FIGURE 25.4 Clinical case depicting the transcrestal sinus floor elevation (...

FIGURE 25.5 General pictorial depiction of the hydraulic transcrestal sinus...

FIGURE 25.6 Osseous densification approach. (A) Initial incisions are made a...

FIGURE 25.7 Clinical case depicting the osseous densification approach. (A) ...

FIGURE 25.8 Graft resorption may spontaneously occur during the remodeling p...

FIGURE 25.9 Graft volume relates to elevation height. (A) 0.1 cc of bone gra...

Chapter 26

FIGURE 26.1 Occlusal view showing the muco-gingival junction and limited buc...

FIGURE 26.2 The U-shape incision to the buccal with parallel vertical incisi...

FIGURE 26.3 Full-thickness flap elevated, exposing the implant.

FIGURE 26.4 Flap sutured at the needed coronal level matching the adjacent m...

FIGURE 26.5 6 weeks’ healing revealing a good band of keratinized tissue wit...

FIGURE 26.6 Buccal view showing the soft tissue buccal discrepancy.

FIGURE 26.7 The implant was disconnected (A) to let the tissue grow over it...

FIGURE 26.8 The trapezoidal-shaped incision was made on the palatal side to...

FIGURE 26.9 Tissue was rolled under the pouch, made buccal, and part of it w...

FIGURE 26.10 8 weeks’ healing of the rolled tissue. (A) Buccal view; (B) Pal...

FIGURE 26.11 Final prosthesis in place with marginal tissue matching the adj...

FIGURE 26.12 The focus in this case is the implant in the position of the up...

FIGURE 26.13 A full-thickness bed was made in the area of the recipient site...

FIGURE 26.14 A thick connective tissue graft was harvested from the palate f...

FIGURE 26.15 The free connective tissue was secured coronally to the recipie...

FIGURE 26.16 6 months’ healing showing the keratinized tissue gained, which...

FIGURE 26.17 Purulent exudate and a lack of keratinized tissue with recessio...

FIGURE 26.18 The procedure began with debridement and elevation of a full-th...

FIGURE 26.19 Once the flap was elevated, it was confirmed that the implant w...

FIGURE 26.20 High-speed handpiece and irrigation were used to perform implan...

FIGURE 26.21 A cancellous mineralized allograft bone graft was placed in the...

FIGURE 26.22 A thick connective tissue graft was harvested from the palate f...

FIGURE 26.23 The flap was elevated over the donor tissue and both the flap a...

FIGURE 26.24 8-year follow-up shows thick, firm pink healthy tissue surround...

FIGURE 26.25 (a) There was thin tissue and a shallow vestibule in the area o...

FIGURE 26.26 The allograft dermis was sutured in place and the vertical inci...

FIGURE 26.27 The area healed and providing a good vestibule for good plaque...

FIGURE 26.28 Maxillary posterior prior to placement of two adjacent implants...

FIGURE 26.29 A U-shape flap as described previously is made with full-thickn...

FIGURE 26.30 After the healing abutments were placed and the flap secured at...

FIGURE 26.31 (A) Note the abundant keratinized soft tissue height and papill...

FIGURE 26.32 A 24-year-old female presented with composite restored centrals...

FIGURE 26.33 An atraumatic extraction was done.

FIGURE 26.34 The socket was grafted with a layered cancellous, cortical mine...

FIGURE 26.35 Harvesting of the connective tissue starts from the disto-lingu...

FIGURE 26.36 (A, B) The pediculated rotated subepithelial connective tissue...

FIGURE 26.37 6 months’ healing (A) buccal and (B) palatal views of the site...

FIGURE 26.38 A three-dimensional printed digital guide for implant placement...