PMC3134050_01
Preoperative orthopantamograph
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F2
A provisional diagnosis of Generalized Chronic Periodontitis was made, which was well-supported by the supplemental evidence of generalized horizontal bone loss, as observed in the Orthopantomograph [Figure 2] and a full set of intraoral periapical radiographs taken.
Clinical site of surgery
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F3
The chin was degloved (intra-oral surgical exposure of the bony mandibular chin) till the inferior border of the mandible [Figure 3].
Graft harvested
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F4
A corticocancellous block bone graft (2 cm lengthx1 cm breadth) was harvested from the inferior border of the mandible (J graft) [Figure 4].
Ridge split
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F5
The graft was tunneled and positioned on the crestal ridge and secured using a standard microscrew (1.5mm diameter) [Figures 5-7].
J-shaped bone
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F6
The graft was tunneled and positioned on the crestal ridge and secured using a standard microscrew (1.5mm diameter) [Figures 5-7].
Graft in place
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F7
The graft was tunneled and positioned on the crestal ridge and secured using a standard microscrew (1.5mm diameter) [Figures 5-7].
Sub-epithelial connective graft
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F8
The graft was trimmed and positioned appropriately onto the recipient site [Figures 8 and 9].
Connective tissue graft from palate
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F9
The graft was trimmed and positioned appropriately onto the recipient site [Figures 8 and 9].
Immediate postoperative OPG
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F10
Immediate postoperative orthopantamograph was taken to see if the graft and screws are secure [Figure 10] instructions were reinforced.
After six months
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F11
Six months following the augmentation procedures, an orthopantamograph (OPG) was repeated and increased radiopacity was observed in relation to the alveolar ridge of the lower anterior region, suggestive of the regeneration of an adequate amount and height of the alveolar bone in that region (6 mmx3 mm) [Figure 11].
Implant placement
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F12
Implant osteotomy was performed up to a diameter of 3.2mm and two implants (3.75x13 mm, Lifecare) were placed [Figure 12].
Implants in sound bone
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F13
Primary stability of 40 N was achieved [Figure 13] and cover screws were placed.
Provisonal restoration
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F14
The patient was rehabilitated with a provisional restoration to restore esthetics [Figure 14].