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Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel
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1/34 - Planning the surgery with CoDiagnostix® for Straumann® Guided Surgery
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
2/34 - Initial situation 3 months after 21 extraction: missing central upper left incisor retained with a bridge
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
3/34 - Buccal bone loss already visible
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
4/34 - CBCT scan reveals vertical and horizontal bone loss; lost due to inflammation and apical lesions
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
5/34 - Drill guide
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
6/34 - Situation 3 months after tooth 21 extraction and template in place
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
7/34 - Crestal view shows right position of guide and healthy soft tissue
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
8/34 - Visible bone loss after full flap elevation
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
9/34 - Periostal releasing incisions - flap mobilisation and elongation
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
10/34 - Measuring the defect with a trephine: 7 mm ring required
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
11/34 - Guided pilot drilling with Straumann BLT Pilot Drill 2.2 mm diameter
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
12/34 - Trephine drilling: guiding pin follow the pilot drilling path; depth of drilling in this case: 4-5 mm.
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
13/34 - Collecting bone particles
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
14/34 - Ring bed preparation with 7 mm diameter planator - the same size as the trephine was used
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
15/34 - Situation after 7 mm planator was used
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
16/34 - Crestal view
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
17/34 - Bone ring measurement: setting the bone ring in the defect to measure the height and fit
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
18/34 - bonering fix to hold the ring in a safe manner and measure the height
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
19/34 - Adjustment of maxgraft® bonering length with a diamond disc
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
20/34 - Enlargement of the inner diameter with the Straumann® BLT profile drill
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
21/34 - Final drilling with the 2.8 mm BLT drill through the guide to enlarge the to fit the Straumann® BLT NC (3.3 mm) implant
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
22/34 - Situation after final preparation
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
23/34 - maxgraft® bonering in place
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
24/34 - Implant placement: Straumann® BLT NC 3.3/12 mm SLActive
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
25/34 - maxgraft® bonering fixated with the implant in the defect
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
26/34 - Smooth the sharp edges with the diamond tulip (diameter 3 mm)
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
27/34 - maxgraft® bonering fixated with the implant in the right position
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
28/34 - Tacking a Jason® membrane with pins
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
29/34 - Cover the ring with cerabone® small particles as resorption protection
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
30/34 - The defect is completely covered with Jason® membrane
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
31/34 - Cover the augmented area with the flap and suture without tension
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
32/34 - Mattress sutures to remove tension of muscles
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
33/34 - Suturing the flap
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel -
34/34 - Adhesive temporary restoration in place
Guided bone ring procedure in aesthetic zone - Dr. K. Chmielewski & Dr. O. Yüksel
Vertical augmentation: Preparation of ring bed in atrophic mandibula (third quadrant)
Initial situation pre-op: Central incisors with mobility 3
X-ray scan: initial situation loss of two wall bony defect with loss of buccal and lingual lamella
Initial situation: single tooth gap in regio 22
Initial presentation of failing post retained crown with previous history of failed apicectomies and amalgam tattooing and scar tissue
Pilot drilling in the recipient site
X-ray scan of clinical situation
Initial situation 57-year old female patient. X-ray scan reveals severe bone loss due to inflammation in region 13. Treatment plan was extraction of teeth 13 and 14 and augmentation after healing.
X-ray scan reveals initial situation with maxillary bone height in regio 15 of 1.5 mm
Initial situation: bone loss due to lack of physical load of bridge retained region 11
Bone defect in the aesthetic zone.
Initial situation: missing incisor with loss of buccal wall
Severe periimplantitis at tooth 15 with bone loss up to 1/3 of the implant
Initial situation: X-ray scan reveals eggshell thin sinus floor (1-3 mm) on both sites of the maxilla; green areas indicate the planned maxgraft® bonerings and red areas the planned implants
Initially bridge retained incisors
