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Quintessence International



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Quintessence Int 45 (2014), No. 3     24. Jan. 2014
Quintessence Int 45 (2014), No. 3  (24.01.2014)

Page 203-208, doi:10.3290/j.qi.a31207, PubMed:24570987

Negotiating the severely resorbed extraction site: A clinical case report with histologic sample
Wang, Chin-wei / Koo, Samuel / Kim, David / Machtei, Eli E.
The treatment of an infected socket with a severe facial dehiscence/ fenestration defect presents a therapeutic dilemma to the dental team. Both implant-supported restoration and fixed partial denture are viable options to restore function and occlusion, each with its benefits and disadvantages. In the present case report, a multi-stage regenerative approach was selected to enable implant-supported single crown. The first phase of the treatment after extraction of the maxillary central incisor was the stabilization of the blood clot with a collagen plug. Six weeks later, the surgical site was re-entered and the socket was grafted with biphasic calcium sulfate (BCS). Six months later, a dental implant was placed and a core biopsy taken. However, the central portion of the facial defect demonstrated only partial regeneration resulting in exposure of six implant threads. Freeze-dried bone allograft (FDBA) and a collagen membrane were utilized to augment the ridge and cover the exposed threads. The histology of the bone core showed a complete resorption of the grafted material with the presence of new woven bone throughout the specimen. Clinically, complete defect regeneration and augmentation of the alveolar ridge were attained after 4 months. Thus, the clinician should consider the pros and cons of this regenerative approach along with other more conservative treatment alternatives when dealing with similar cases.

Keywords: biphasic calcium sulfate, collagen membrane, collagen plug, freeze-dried bone allograft, guided bone regeneration, histology, ridge augmentation, socket preservation