Lateral and vertical bone regeneration with simultaneous soft tissue augmentation

The Situation

• After extraction of the periodontally damaged tooth (35) the preoperative CBCT imaging shows reduced vertical bone volume in sector 35–37. A lateral and vertical bone regeneration was necessary.
• The goal of treatment was a late implant placement after bone regeneration and creation of stable periimplant soft tissue for long-term implant preservation.

The Approach

• Customized Bone Regeneration (Yxoss CBR®)
• Coverage of the graft with Geistlich Bio-Gide® for the purpose of Guided Bone Regeneration (GBR)
• Soft tissue thickening using Geistlich Fibro-Gide® implantation
• Vestibuloplasty with Geistlich Mucograft® for regeneration of keratinized mucosa

The Outcome

• Approx. 5 mm of vertical bone regeneration
• The potential occurrence of a dehiscence associated with a wound opening and exposure of Yxoss CBR® was able to be prevented with Geistlich Fibro-Gide®.
• On one hand, the quality of the periimplant soft tissue was improved by the soft tissue thickening with

Key to Success

• Preoperative professional dental cleaning
• Fixing the titanium scaffold
• Full coverage of Yxoss CBR® with Geistlich Bio-Gide® and Geistlich Fibro-Gide®
• Completely tension-free wound closure (wound edges should overlap by 5–10 mm)
• Creation of an at least 2–3 mm wide zone of keratinized mucosa around the implants