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Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva
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01/33 - Initial situation - A young female 34 years old lost her front teeth in an surfing accident and she had a 5 unit bridge supported by her upper left lateral and right canine. The restoration failed and both supporting crowns have exposed and leaking margins.
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
02/33 - Initial situation - A young female 34 years old lost her front teeth in an surfing accident and she had a 5 unit bridge supported by her upper left lateral and right canine. The restoration failed and both supporting crowns have exposed and leaking margins.
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
03/33 - Elevating the surgical flap and cleaning the surgical area from the granulation tissue
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
04/33 - Cortectomy was performed with high speed round burr
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
05/33 - Shaping and preparing of permamem®.
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
06/33 - Membrane adaptation with fixation screws on the buccal side
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
07/33 - Horizontal bone regeneration using layering technique with initial layer of maxgraft® particles mixed with cerabone® (0.5- 1.0 mm)
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
08/33 - Horizontal bone regeneration using layering technique with initial layer of maxgraft® particles mixed with cerabone® (0.5- 1.0 mm)
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
09/33 - Second layer of cerabone® (0.5- 1.0) of 0.5 cc to create convexity
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
10/33 - Second layer of cerabone® (0.5- 1.0) of 0.5 cc to create convexity
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
11/33 - Stabilizing the membrane palatal with 4/0 proline sutures.
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
12/33 - Stabilizing the membrane palatal with 4/0 proline sutures
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
13/33 - Final sutures closed under no tension and fixing and adjusting the temporary bridge
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
14/33 - Final sutures closed under no tension and fixing and adjusting the temporary bridge
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
15/33 - Initial situation - 24 w after initial horizontal GBR. permamem® is intact and kept the graft in stabile position. Acceptable ridge countering has been achieved and membrane has been removed
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
16/33 - Initial situation - 24 w after initial horizontal GBR. permamem® is intact and kept the graft in stabile position. Acceptable ridge countering has been achieved and membrane has been removed
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
17/33 - Stability and density of the bone graft particles after membrane removal
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
18/33 - Stability and density of the bone graft particles after membrane removal
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
19/33 - Implant placement in the correct 4D position following the prosthetically driven placement. For central incisions in the cingulum region
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
20/33 - Implant placement in the correct 4D position following the prosthetically driven placement. For central incisions in the cingulum region
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
21/33 - Guided bone regeneration after implant placement using cerabone® (0.5- 1.0 mm) shaped to create convexity and covered by two mucoderm® (15x20 mm) used as a soft tissue graft as well as a membrane over the cerabone®. mucoderm® was stabilised with stabilising sutures on each side
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
22/33 - Guided bone regeneration after implant placement using cerabone® (0.5- 1.0 mm) shaped to create convexity and covered by two mucoderm® (15x20 mm) used as a soft tissue graft as well as a membrane over the cerabone®. mucoderm® was stabilised with stabilising sutures on each side
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
23/33 - Closure sutures and fit of the temporary bridge - cemented on the adjacent peeped teeth
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
24/33 - Closure sutures and fit of the temporary bridge - cemented on the adjacent peeped teeth
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
25/33 - Preparation and fit of fixed screw retained temporary bridge and temporary crowns of the adjacent teeth for soft tissue contouring 18 weeks after implant placement
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
26/33 - Impression and customising the impression pick ups and taking an implant impression for UR1 and UL1 implants with open tray technique 22 weeks after implant placement
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
27/33 - Impression and customising the impression pick ups and taking an implant impression for UR1 and UL1 implants with open tray technique 22 weeks after implant placement
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
28/33 - Final cement retained porcelain implant crowns on CAD/CAM Ti abutments
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
29/33 - Final cement retained porcelain implant crowns on CAD/CAM Ti abutments
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
30/33 - Final cement retained porcelain implant crowns on CAD/CAM Ti abutments
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
31/33 - Final result 3 months after implant placement surgery and 2 weeks after final prosthetic integration , showing sufficient ridge contouring around the UR1 and UL1 dental implants and satisfactory peri-implant soft tissue thickness
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
32/33 - Final result 3 months after implant placement surgery and 2 weeks after final prosthetic integration , showing sufficient ridge contouring around the UR1 and UL1 dental implants and satisfactory peri-implant soft tissue thickness
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva -
33/33 - Smile line and harmonisation of white and pink aesthetic.
Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva
Initial clinical situation.
Initial clinical situation.
Initial clinical situation.
Baseline clinical situation.
Grafting of the extraction socket with small cerabone® granules.
Situation before tooth extraction
Situation after tooth extraction.
Initial situation - A young female 34 years old lost her front teeth in an surfing accident and she had a 5 unit bridge supported by her upper left lateral and right canine. The restoration failed and both supporting crowns have exposed and leaking margins.
Tooth 16 furcation involvement with gingival marginal recession and large Class 5 filling
Pre-surgical situation.
Initial clinical situation.
Initial clinical situation showing bone wall defect.
Pre-operative situation. Lateral view.
Situation before tooth extraction.
Situation after tooth extraction.
Initial clinical situation with pronounced vertical and horizontal bone defect
Initial panoramic x-ray with failing tooth 16
Implant placed in the deficient site. permamem® in place for covering.
Initial clinical situation. Atrophic maxillary ridge.
Intra-operative view.
Extraction socket with bone wall defect
Immediately placed implant covered with permamem®. permamem® passively immobilized by sutures and intentionally left exposed to the oral cavity.
Baseline clinical situation.
