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Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts
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1/28 - Initial situation: 40 year old female patient with extensive scar tissue after several surgeries restored with a Rochette bridge
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
2/28 - Pre op radiograph
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
3/28 - Clinical situation after removal of Rochette showed clearly extensive hard and soft tissue volume loss
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
4/28 - CBCT scan: Very large horizontal offset and massively reduced bone volume
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
5/28 - 6 months post extraction the block augmentation was performed. Large flap from the mesial of the upper left 1 to distal upper left 3 with a remote palatal and periosteal relieving incision
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
6/28 - maxgraft® block 10 x 10 x 10 mm
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
7/28 - Block fixated with Straumann bone fixation kit to provide excellent primary stability of the block graft
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
8/28 - cerabone® used to augment around the edges of the block graft
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
9/28 - Jason® membrane used to cover the graft to prevent soft tissue inclusion
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
10/28 - Platelet Rich Growth Factor technique on top of membrane to help improve soft tissue healing
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
11/28 - Sutures free of tension
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
12/28 - The recemented Rochette bridge already showed improved emergence profile of the pontic
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
13/28 - Post op x-ray showed good block fixation and volume
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
14/28 - 2 weeks post-op: Excellent healing of hard and soft tissues
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
15/28 - CBCT scan 4 months post-op: Graft was fully integrated
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
16/28 - Clinical situation before implantation already showed improved aesthetics
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
17/28 - Single sided flap to expose the healed block graft
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
18/28 - Implantation of STRM BLT Implant 3.3 mm
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
19/28 - Emdogain applied over the grafted surface to encourage soft tissue healing and a 2 mm healing abutment used to try and tent the soft tissues to gain thickness of the connective tissue
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
20/28 - Post op x-ray showed good placement of implant and stable bone conditions
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
21/28 - Site closed uneventfully with vicryl rapide sutures
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
22/28 - 8 weeks post-op: Satisfying soft tissue conditions after removal of the Rochette bridge
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
23/28 - Placement of a mono scanbody to take a digital scan
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
24/28 - Screw retained crown with a customised cad/cam abutment
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
25/28 - Clinical situation after surgery
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
26/28 - Post- op x-ray showed excellent seating of the restoration and good bone levels
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
27/28 - 6 weeks post: Fit of final restoration
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts -
28/28 - Excellent ridge reconstruction with maxgraft® block
Block augmentation with maxgraft® in the maxilla - Dr. R. Cutts
Initial clinical situation. Atrophic maxillary ridge.
Initial x-ray showing bone loss around implants placed 5 years ago in another dental clinic
Initial view of the case. Discoloration of 1.1 and mild class I gingival recession
Situation after tooth removal.
Initial clinical situation with gum recession and labial bone loss eight weeks following tooth extraction
Three implants placed in a narrow posterior mandible
Pre-operative clinical situation.
Clinical situation with narrow alveolar ridge in the lower jaw
recession on tooth 11
Initial clinical situation, regio #16
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
Pre-operative situation showing tooth 21 with deep periodontal pocket. Tooth presented with mobility grade III.
Pre-op picture of affected teeth 11 and 21
Preoperative radiological situation
Atrophic alveolar ridge in the left mandible
Clinical view of the case.
Intra-operative view.
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.
Preoperative CBCT: vertical bone defects in the 3rd & 4th quadrant
Initial clinical situation with pronounced vertical and horizontal bone defect
Clinical view 8 weeks after extraction of teeth 25 and 26
Initial x-ray, tooth 25 compromised and to be extracted
Preoperative x-ray, severe bone atrophy
Loss of teeth in anterior maxilla caused by periodontitis
Initial situation with broken tooth 46
Probing demonstrates peri-implant pocket depth of 8 mm
Initial clinical situation.
Pre-surgical situation.
Initial situation: missing teeth #11 & 12 and badly broken #21 root
Pre-operative OPG shows deep vertical intrabony defects on the distal aspects of teeth 13 and 14.
Instable bridge situation with abscess formation at tooth #15 after apicoectomy
Initial clinical situation.
Implant insertion in atrophic alveolar ridge
Preoperative clinical situation
Pre-operative radiographic view.
Situation after tooth extraction.
Pre-operative radiograph. Intrabony defect on the mesial aspect of tooth 14.
Initial 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.
Extraction socket grafted with cerabone.
Grafting of the extraction socket with small cerabone® granules.
Lateral view of the defect in the posterior right maxilla.
Clinical situation of the edentulous distal maxilla before the surgery
Situation before augmentation, atrophic alveolar ridge
Clinical situation before augmentation
Initial clinical situation.
Initial clinical situation.
Initial situation with fractured central incisors
Initial CBCT scan - Fracture of left maxillary incisor and loss of buccal wall
Pre-operative: loss of interdental papilla between 12 and 11 associated with gingival inflammation and pus
Preoperative x-ray, multiple residual cysts of the upper jaw
The patient presented with severe pain in the lateral incisor and a deficient adhesive provisional. Bruxism resulted in canine loss and premature contact in the lateral incisor.
Pre-operative X-ray. Hopless tooth 21.
Pre-surgical situation. Teeth 26 and 27 missing.
Extraction of tooth 21 after endodontic treatment
Pre-surgical probing reveals a deep intrabony defect on the distal aspect of the upper canine.
Initial clinical situation with single tooth gap in regio 21
Pre-operative radiographic view. Intrabony defect on the distal aspect of the lateral incisor.
Clinical situation before extraction and implantation
Initial clinical situation showing bone wall defect.
Initial clinical situation with broken bridge abutment in regio 12 and tooth 21 not worth preserving
Clinical situation before surgery
Initial situation pre-op: Central incisors with mobility 3
Initial situation: 40 year old female patient with extensive scar tissue after several surgeries restored with a Rochette bridge
Initial situation after extraction of tooth 21 after 6 months
Initial clinical situation: Bone defect in the upper right maxilla (teeth #14-16)
OPG of the initial situation – provision of missing denture in regio 44 to 47 by a resin-retained bridge
Initial view of the clinical case: Class III malocclusion
Treatment plan: Regenerative corticotomy (PAOO)
Situation before extraction with single tooth crowns on 21 and 22
Preoperative CBCT analysis
The patient presented with pathologic mobility of upper left central incisor. Radiographic examination revealed significant circumferential attachment loss with an unfavorable crown to root ratio.
Initial situation – Treatment plan: Replace the adhesive upper left central incisor bridge with a dental implant
Initial presentation of failing post retained crown with previous history of failed apicectomies and amalgam tattooing and scar tissue
The patient presented with a terminal fracture of the crown tooth number 12
Initial clinical situation - Central incisors with dental destruction and periapical pathology
47 years old patient referred by another dentist after suffering a fall while fishing
Initial situation at position #16
Initial situation: Exposure of tooth root in position 27
