Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

1/35 - Initial situation – Treatment plan: Replace the adhesive upper left central incisor bridge with a dental implant

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
2/35 - Advanced bone loss after traumatic tooth loss more than 10 years ago

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
3/35 - CBCT: Advanced bone loss after traumatic tooth loss more than 10 years ago

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
4/35 - Patient used to have a diastema in the area which she no longer wanted to be recreated. Treatment plan: implant for UL1 and a veneer for the UR1 to match the space analysis and achieve acceptable and symmetrical aesthetic outcome

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
5/35 - Three-sided full thickness flap and cleaning the surgical area from the granulation tissue

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
6/35 - Three-sided full thickness flap and cleaning the surgical area from the granulation tissue

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
7/35 - Shaping and preparing the uni-cortical maxgraft® block using straight hand-piece under copious irrigation to fit the surgical field and to ensure good adaptation

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
8/35 - Shaping and preparing the uni-cortical maxgraft® block using straight hand-piece under copious irrigation to fit the surgical field and to ensure good adaptation

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
9/35 - Stabilisation of the bone block with two 10 mm fixation screws placed oblique. Sharp edges of the block were polished to avoid defeasance in the soft tissue healing

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
10/35 - Stabilisation of the bone block with two 10 mm fixation screws placed oblique. Sharp edges of the block were polished to avoid defeasance in the soft tissue healing

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
11/35 - Layer of maxgraft® cancellous particles used to fill any gaps and to allow smooth contour medially and distally and covering with Jason® membrane

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
12/35 - Layer of maxgraft® cancellous particles used to fill any gaps and to allow smooth contour medially and distally and covering with Jason® membrane

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
13/35 - Soft tissue adjustment - frenulum adjustment and muco-periosteal release to achieve full closure under no tension to allow the flap margins to heal with primary intension

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
14/35 - Soft tissue adjustment - frenulum adjustment and muco-periosteal release to achieve full closure under no tension to allow the flap margins to heal with primary intension

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
15/35 - Flap closure using 5/0 monofilaments Prolene sutures

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
16/35 - Flap closure using 5/0 monofilaments Prolene sutures

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
17/35 - Six months healing period was allowed - healthy soft tissue contour, satisfactory convexity

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
18/35 - Six months healing period was allowed - healthy soft tissue contour, satisfactory convexity

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
19/35 - Post op CBCT shows well integrated and remodelled bone block with sufficient augmentation

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
20/35 - Post op CBCT shows well integrated and remodelled bone block with sufficient augmentation

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
21/35 - Osteotomy prepared revealing a well integrated and nourished bone block. Prostheticly driven implant placement (Straumann Roxolid BLT - RC 4.1x 10 mm) - using a pre-fabricated surgical guide of the approved wax up

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
22/35 - Osteotomy prepared revealing a well integrated and nourished bone block

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
23/35 - Implant is placed 3 mm away from the cementoenamel junction. Good primary stability was achieved with a torque of 35 Nom at placement and good block integration

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
24/35 - 4.5 mm diameter x 4 mm height healing abutment

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
25/35 - GBR at the time of the implant placement - added cerabone® 0.5 cc small particles to increase the convexity and insure stability of the soft tissue. Jason® membrane stabilised with titanium pins and sutured palatally

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
26/35 - GBR at the time of the implant placement - added cerabone® 0.5 cc small particles to increase the convexity and insure stability of the soft tissue. Jason® membrane stabilised with titanium pins and sutured palatally

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
27/35 - Exposure of the UL1 implant and fitting a chair side temporary crown

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
28/35 - Exposure of the UL1 implant and fitting a chair side temporary crown

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
29/35 - Final implant impression with Straumann RC customised impression pick up with an open tray for final screw retained implant crown on UL1 and Porcelain veneer on UR1

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
30/35 - Final implant impression with Straumann RC customised impression pick up with an open tray for final screw retained implant crown on UL1 and Porcelain veneer on UR1

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
31/35 - Final fit of final screw retained implant crown with CAD/CAM Ti abutment on UL1 and Porcelain veneer on UR1. Lab work was provided by Ceramist Guglielmo Parziale - Napoli - Italy

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
32/35 - 5 years clinical review – stable outcome

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
33/35 - 5 y post op CBCT - Axial view at the coronal 2mm level

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
34/35 - 5 y post op CBCT - Coronal view showing the upper left central incisor implant

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva
35/35 - 5 y post OP CBCT -Sagittal view

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Ridge preservation with permamem®, maxgraft® granules and autologous bone - Dr. E. Valdimarsson

Baseline clinical situation.

Ridge preservation with maxgraft®, mucoderm® & Jason® membrane - Dr. F. Rojas-Vizcaya

Ridge preservation with maxgraft®, mucoderm® and Jason® membrane - Dr. Fernando Rojas-Vizcaya

Situation before extraction of the teeth

Soft tissue thickening at immediate implant placement and GBR with mucoderm® and maxgraft® - Dr. A. Puisys

Soft tissue thickening at immediate implant placement with GBR - Dr. A. Puisys

Initial clinical situation

GBR using layering technique in aesthetic zone with maxgraft® and cerabone® -Dr. H. Maghaireh and Dr. V. Ivancheva

Initial situation after extraction of tooth 21 after 6 months

Single tooth restoration with maxgraft® cortico - Dr. K. Chmielewski

Augmentation with maxgraft® cortico - Dr. K. Chmielewski

Preparation of a single tooth defect with severely resorbed vestibular wall

Treatment of a fenestration defect using maxgraft® and permamem® - Dr. Y. Kassem

Initial clinical situation.

Full arch GBR using cerabone®, maxgraft® and Jason® membrane with simultaneous implantation of 6 Straumann® implants - Dres. A. Signorio and G. Molina

Full arch GBR using botiss cerabone®, maxgraft® and Jason® membrane with simultaneous implantation of 6 Straumann® implants - Dres. A. Signorio and G. Molina

Initial clinical situation

Reconstruction of a single tooth defect with the shell technique - Dr. Andoni Jones

Initial clinical situation

Excellent aesthetic result of buccal augmentation with mucoderm® and maxgraft® after immediate implant placement - 3-years follow-up - Dr. A. Puišys

Initial situation

Posterior socket preservation using maxgraft® and permamem® - Dr. C. Landsberg & Prof. N. Bichacho

Tooth 16 furcation involvement with gingival marginal recession and large Class 5 filling

Full maxillary reconstruction with maxgraft® bonebuilder - Dr. C. Hilscher

Initial x-ray, ten years post implantationem alio loco, large peri-implant bone loss

Ridge preservation using permamem® and maxgraft® granules - Dr. A. Wöst

Extraction socket with bone wall defect

Socket preservation with permamem® and maxgraft® granules - Dr. P. Di Capua

Situation before tooth extraction

Soft tissue thickening at early implant placement and GBR with mucoderm® and maxgraft® - Dr. A. Puisys

Soft tissue thickening at early implant placement-Puisys

Initial clinical situation

Type II socket defect grafted and repaired in a flapless way using Jason® membrane and maxgraft® cortico-cancellous - Dr. A. Jones

Baseline

Entire papilla preservation technique (EPP) for the regenerative treatment of a severely compromised central incisor - Dr. S. Aslan

EPP for the treatment of a deep intrabony defect

Initial X-ray presenting a very deep intrabony defect of tooth 21

Implant placement and bone augmentation in the aesthetic zone using maxgraft® and permamem® - Dr. A. Puišys

Implant placed in the deficient site. permamem® in place for covering.

Block grafting in the aesthetic zone with maxgraft®, Jason® membrane and cerabone® - Dres. H. Maghaireh and V. Ivancheva

Initial situation – Treatment plan: Replace the adhesive upper left central incisor bridge with a dental implant

Simultaneous implantation and ridge augmentation using maxgraft® cortico, maxgraft® granules and mucoderm® - Dr. A. Puišys

Occlusal view of attached maxgraft® cortico at the buccal site

Maxillary sinus cyst removal using the Crocodile Technique and subsequent lateral sinus lift - Dres. C. Scognamiglio and A. Perucchi

Maxillary sinus cyst removal using the Crocodile Technique and subsequent lateral sinus lift with cerabone®, maxgraft® and Jason® membrane - Dres. C. Scognamiglio and A. Perucchi

Initial x-ray, tooth 25 compromised and to be extracted

GBR in aesthetic zone with maxgraft® and Jason® membrane - 5 year follow up - Dr. A. Jones

Clinical situation at baseline: Situation after tooth extraction UR1 due to a failed endodontic treatment 3 months previously

Socket augmentation using mucoderm®, maxgraft® and Straumann® Emdogain® - Dr. A. Puišys

Alveolar socket before soft and hard tissue augmentation

Socket preservation with mucoderm® & maxgraft® - Dr. A. Puisys

Pre-operative situation; tooth 21 proved not to be worth preserving

Horizontal/vertical GBR using cerabone®/maxgraft®, Jason® membrane/collprotect® membrane and Ti-mesh - Dr. A. Aziz

Initial clinical situation

Immediate implants in teeth number 12 and 11, with dual zone grafting using maxgraft® granules - Dr. A. Jones

Initial situation

Treatment of a combined horizontal and vertical bone defect in the maxilla with maxgraft® cortico in the allogenic shell technique - Dr. R. Würdinger

Clinical situation

Full bone regeneration in extraction socket augmented with maxgraft® and Jason® membrane – Dr. C. Landsberg

Initial clinical situation: 9 mm pocket depth associated with root fracture

Horizontal GBR using permamem®, cerabone® and maxgraft® granules and soft tissue augmentation with mucoderm® - Dres. H. Maghaireh and V. Ivancheva

botiss-cerabone-permamem-maxgraft-mucoderm-horizontal-gbr-maghaireh

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.

Simultaneous GBR and implantation using maxgraft® granules and autologous bone - Dr. A. Jones

Initial situation - endodontically failing tooth 22, very thin biotype, high lip line and esthetic expectations

Sinus lift and lateral bone augmentation with cerabone® and maxgraft® - Dr. D. Chavarri Prado

Sinus lift and lateral bone augmentation with botiss cerabone® and maxgraft® - Dr. D. Chavarri Prado

Preoperative x-ray, severe bone atrophy

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva

Initial situation - broken and missing upper right central incisor (UR1). This tooth was removed long time ago and there were signs of bone loss and resorption due to the bone remodelling. Patient was also undergoing orthodontic treatment due to the loss of mesio-distal space.