PMC3636934_01
Pre-operative intraoral periapical radiograph of the edentulous site
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F1
Necessary investigations like complete hemogram, intra-oral periapical (IOPA) radiograph [Figure 1], and computed tomographic (C.T.) scan of the edentulous site were done [Figures 2-4]).
Computed tomographic scan showing the labio-palatal width of the available bone at the edentulous site
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F2
Necessary investigations like complete hemogram, intra-oral periapical (IOPA) radiograph [Figure 1], and computed tomographic (C.T.) scan of the edentulous site were done [Figures 2-4]). C.T. scan measurements revealed inadequate bone volume labio-palatally to accommodate a standard-diameter implant [Figure 2].
Computed tomographic scan showing the mesio-distal width of the available bone at the edentulous site
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F3
Necessary investigations like complete hemogram, intra-oral periapical (IOPA) radiograph [Figure 1], and computed tomographic (C.T.) scan of the edentulous site were done [Figures 2-4]).
Computed tomographic scan showing the height of the available bone at the edentulous site
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F4
Necessary investigations like complete hemogram, intra-oral periapical (IOPA) radiograph [Figure 1], and computed tomographic (C.T.) scan of the edentulous site were done [Figures 2-4]).
Six-week photograph of the implant
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F5
Intraoral periapical (IOPA) radiograph revealed bone loss on both mesial and distal aspects of the implant [Figures 5 and 6].
Six-week intraoral periapical radiograph of the implant showing bone loss mesial and distal to the implant
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F6
Intraoral periapical (IOPA) radiograph revealed bone loss on both mesial and distal aspects of the implant [Figures 5 and 6].
Circumferential defect around the failing implant
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F7
AG, Basel, Switzerland). A circumferential defect with slight buccal bone loss was evident around the implant [Figures 7 and 8].
Circumferential defect with slight buccal bone loss around the failing implant
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F8
AG, Basel, Switzerland). A circumferential defect with slight buccal bone loss was evident around the implant [Figures 7 and 8].
Decontamination by supersaturated solution of citric acid
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F9
Next, surface decontamination was done by applying a supersaturated solution of citric acid for 30 s followed by complete rinsing of the site with normal saline [Figure 9].
PerioGlas  being carried to the peri-implant defect
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F10
The peri-implant defect was filled with PerioGlas  (NovaBone Products, LLC, Alachua, Florida, USA) starting from the bottom of the defect [Figures 10 and 11].
Peri-implant defect filled with PerioGlas
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F11
The peri-implant defect was filled with PerioGlas  (NovaBone Products, LLC, Alachua, Florida, USA) starting from the bottom of the defect [Figures 10 and 11].
Trimmed and shaped resorbable collagen membrane (Healiguide )
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F12
Ltd., Chennai, India) was trimmed and adapted over the entire defect so as to cover 2-3 mm of the surrounding alveolar bone and to ensure stability of the graft material [Figures 12 and 13].
Resorbable collagen membrane (Healiguide ) adapted over the periimplant defect
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F13
Ltd., Chennai, India) was trimmed and adapted over the entire defect so as to cover 2-3 mm of the surrounding alveolar bone and to ensure stability of the graft material [Figures 12 and 13].
Primary wound closure achieved using non-resorbable 3-0 black braided silk sutures
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F14
India) for 7 days [Figures 14 and 15].
Surgical area covered with periodontal dressing
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F15
India) for 7 days [Figures 14 and 15].