PMC7301219_01
Initial clinical situation.
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The appearance and consistency of the soft tissues were good (Figure 1).
Initial orthopantomography.
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The orthopantomograph confirmed the agenesis of the upper lateral incisors with a reduced development of the alveolar process in a mesiodistal direction (Figure 2).
Buccal view of the defects on 12 and 22.
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Two monocortical block grafts were collected from the symphysis and fixed at the buccal aspect of the bone defects with osteosynthesis screws (Figures 3-5).
Bone blocks' removal from the mandibular symphysis.
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Two monocortical block grafts were collected from the symphysis and fixed at the buccal aspect of the bone defects with osteosynthesis screws (Figures 3-5).
Bone block stabilization by screws.
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Two monocortical block grafts were collected from the symphysis and fixed at the buccal aspect of the bone defects with osteosynthesis screws (Figures 3-5).
Coverage of the surgical site with deproteinized bovine bone (Bio-Oss , Geistlich Biomaterials, Wolhusen, Switzerland).
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Switzerland) and native lyophilized type I resorbable collagen membranes from equine origin (Paroguide , GABA VEBAS srl, Rome, Italy) were used to cover the block graft at each site (Figure 6).
Implant placement.
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After 6 months of uneventful healing, fixation screws were removed, and two 3.25 x 13 mm implants were placed in a prosthetically guided position with the aid of a surgical stent (Figure 7).
Clinical situation at 8 years.
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Clinical and radiological evaluations were conducted at 8 years (Figures 8 and 9) and 20 years from the prosthetic loading (Figures 10 and 11).
Orthopantomography at 8 years.
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Clinical and radiological evaluations were conducted at 8 years (Figures 8 and 9) and 20 years from the prosthetic loading (Figures 10 and 11). The 8-year orthopantomograph revealed no detectable marginal bone resorption, calculated as the distance between the most apical bone-to-implant contact visible in the scanned image and the implant-abutment connection level at the mesial and distal aspects (Figure 9).
Clinical situation at 20 years.
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Clinical and radiological evaluations were conducted at 8 years (Figures 8 and 9) and 20 years from the prosthetic loading (Figures 10 and 11).
Orthopantomography at 20 years.
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Clinical and radiological evaluations were conducted at 8 years (Figures 8 and 9) and 20 years from the prosthetic loading (Figures 10 and 11). The same measurements were performed in the 20-year orthopantomography (Figure 11); however, it was not possible to obtain reliable data due to metal artifacts.