PMC7352141_01
Initial orthopantomography.
CRID2020-8479502.001.jpg
PMC7352141_01_CRID2020-8479502.001.jpg
fig1
The initial image of orthopantomography is presented in Figure 1.
(a) Intraoral view of the elevated sinus membrane. (b) The sinus graft filling the space under the Schneiderian membrane. (c) Occlusal view of the horizontal ridge augmentation from the first surgery. (d) Labial view of the frontal defect, buccal perforations of the host bone, and, on the distal, the newly formed bone. (e) Occlusal view with the graft in place. (f) Occlusal view after stabilizing the graft with the resorbable membrane:second surgery.
CRID2020-8479502.002.jpg
PMC7352141_01_CRID2020-8479502.002.jpg
fig2
The host site was prepared for the graft with small holes through the buccal cortical plate (Figure 2), and then, we released the buccal flap with a periosteal incision. A-PRF membranes, and A-PRF exudate (Figure 2). A second layer of particulate bovine bone graft mixed with sterile saline was placed over the previous one.
(a) Pre-op CBCT scan of the resorbed maxillary ridge on site 22. (b) Post-op CBCT scan of the newly formed bone on site 22. (c) Pre-op CBCT scan of the resorbed maxillary ridge on site 24. (d) Post-op CBCT scan of the newly formed bone on site 24. (e) Pre-op CBCT scan of the resorbed maxillary ridge on site 26. (f) Post-op CBCT scan of the newly formed bone on site 26. (g) Pre-op CBCT scan of the resorbed maxillary ridge on site 27. (h) Post-op CBCT scan of the newly formed bone on site 27.
CRID2020-8479502.003.jpg
PMC7352141_01_CRID2020-8479502.003.jpg
fig3
The next stage of treatment started one year later, when the patient was reevaluated with a post-op CBCT which showed sufficient bone formation for implant placement (Figure 3).
(a) Cephalometric radiograph made before implant placement. (b) Frontal intraoral view with the restorations. (c) Retroalveolar X-ray at implant uncovery. (d) Orthopantomography with the restorations.
CRID2020-8479502.004.jpg
PMC7352141_01_CRID2020-8479502.004.jpg
fig4
He received an implant-supported composite resin restoration with metal framework for the left maxilla and a removable acrylic partial denture for the mandible (Figure 4).