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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. 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
Initial clinical situation showing bone wall defect.
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 OPG
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
Pre-operative radiographic view.
