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Clinical Cases in Periodontics


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with good initia...Figure 7.2.14 Healing abutment of 6 mm diameter and 3 mm height is used.Figure 7.2.15 Papillary rotation flap used to close around healing abutment....Figure 7.2.16 Panoramic radiograph after implant and sinus lift.Figure 7.2.17 CT scan on the day of the procedure.Figure 7.2.18 Healing of #14 and #15 implants with simultaneous sinus lift a...Figure 7.2.19 Removal of healing abutment from implants #14 and #15.Figure 7.2.20 Digital pantograph of implants #14 and #15. Note satisfactory ...Figure 7.2.21 Full‐contour wax‐up to verify that technician will cut back to...Figure 7.2.22 Crestal window technique is easier if initial bone height is l...

      37 Chapter 7.3Figure 7.3.1 Preoperative frontal view of fractured tooth #11.Figure 7.3.2 Preoperative occlusal view of tooth #11 fractured at the level ...Figure 7.3.3 Probing pocket depth measurements during initial examination.Figure 7.3.4 Preoperative periapical radiograph of fractured tooth #11.Figure 7.3.5 With minimal flap reflection, tooth #11 was extracted. Socket (...

      38 Chapter 7.4Figure 7.4.1 Preoperative clinical presentation of maxillary right quadrant:...Figure 7.4.2 Probing pocket depth measurements during initial visit.Figure 7.4.3 Preoperative radiographs: (A) panoramic radiograph; (B) periapi...Figure 7.4.4 Preoperative CT scan of maxillary right quadrant: (A) panoramic...Figure 7.4.5 Ridge split at sites #3, #4, and #5: (A) residual native bone p...Figure 7.4.6 Postoperative CT scan of maxillary right quadrant: (A) panorami...Figure 7.4.7 Ridge augmented site and implant placement: (A) pre‐augmented a...Figures 7.4.8 Preoperative view.Figure 7.4.9 Preoperative radiograph.Figure 7.4.10 Incision design.Figure 7.4.11 The full‐thickness flap reflection with the surgical guide in ...Figure 7.4.12 (A, B) The sequential osteotome expansion.Figure 7.4.13 Steps followed after osteotome expansion was completed: (A) im...Figure 7.4.14 Postoperative radiograph.Figure 7.4.15 Healing response six months postoperatively.Figure 7.4.16 Implant exposure and healing abutment by means of an apically ...Figure 7.4.17 Placement of a full ceramic esthetic abutment on implant #9 an...Figure 7.4.18 Final delivery of permanent restorations and completion of the...

      39 Chapter 8.1Figure 8.1.1 Preoperative frontal view.Figure 8.1.2 Missing mandibular first molar area.Figure 8.1.3 Tooth #19 was extracted due to large distal caries.Figure 8.1.4 Probing pocket depth measurements.Figure 8.1.5 Occlusal view of the maxillary arch.Figure 8.1.6 Occlusal view of the mandibular arch.Figure 8.1.7 Normal molar occlusal relationship.Figure 8.1.8 Bitewing radiographs depicting the interproximal bone levels.Figure 8.1.9 CT images reveal sufficient bone available for implant placemen...Figure 8.1.10 A surgical template was used to guide angulations of drills.Figure 8.1.11 A wide‐diameter implant was placed in the molar region.Figure 8.1.12 Implant placed in the molar area with appropriate angulation a...Figure 8.1.13 A short healing abutment placed and sutured for primary closur...Figure 8.1.14 A straight prefabricated final abutment was used for restorati...Figure 8.1.15 Final implant‐supported PFM was delivered.Figure 8.1.16 Postoperative periapical radiograph.

      40 Chapter 8.2Figure 8.2.1 Preoperative presentation: tooth #8 is discolored.Figure 8.2.2 A periapical radiograph of the maxillary anteriors.Figure 8.2.3 Preoperative view of tooth #8.Figure 8.2.4 View following the extraction.Figure 8.2.5 The surgical guide.Figure 8.2.6 Implant placed.Figure 8.2.7 Postoperative radiograph.Figure 8.2.8 Preoperative and postoperative view of tooth #8.

      41 Chapter 8.3Figure 8.3.1 Initial clinical and radiographic presentation: fracture of too...Figure 8.3.2 Periodontal charting at the initial consult.Figure 8.3.3 Preoperative view prior to extraction.Figure 8.3.4 After extraction, note preservation of buccal plate.Figure 8.3.5 Pointed trephine to mark implant location precisely.Figure 8.3.6 ASBE trephine to go 1 mm below estimated sinus floor.Figure 8.3.7 Slow speed is used with ASBE trephine.Figure 8.3.8 After ASBE trephine.Figure 8.3.9 Bone core removed.Figure 8.3.10 Flat diamond bur to expose sinus membrane.Figure 8.3.11 Sinus membrane exposed.Figure 8.3.12 Series of mushroom elevators used to detach and elevate sinus ...Figure 8.3.13 Mushroom elevators are also used to make crestal window larger...Figure 8.3.14 Cobra instrument is used to further elevate the sinus membrane...Figure 8.3.15 Movement of sinus membrane is verified to check if membrane pe...Figure 8.3.16 FDBA is introduced to sinus window as well as to socket.Figure 8.3.17 Implant, MegaGen Rescue 6.5 × 10 mm is placed slowly.Figure 8.3.18 An 8‐03 healing abutment is placed to seal the socket and reta...Figure 8.3.19 A 4‐0 gut suture is used to further tighten and seal the socke...Figure 8.3.20 Postoperative CT scan showing bone graft intact under the Schn...Figure 8.3.21 Palatal flap is opened even with a super‐wide diameter healing...Figure 8.3.22 Semilunar coronally positioned flap used to close the palatal ...

      42 Chapter 8.4Figure 8.4.1 Preoperative presentation (frontal view).Figure 8.4.2 High smile line.Figure 8.4.3 Preoperative presentation (occlusal view).Figure 8.4.4 Initial radiograph.Figure 8.4.5 Digital implant planning after import of all files into plannin...Figure 8.4.6 Stereolithographic surgical template in place (occlusal view)....Figure 8.4.7 Implant placement in an ideal prosthetically driven position wi...Figure 8.4.8 Postoperative clinical situation (occlusal view).Figure 8.4.9 Fixed provisionalization with provisional implant‐supported sc...Figure 8.4.10 Provisional implant‐supported screw‐retained single crowns aft...Figure 8.4.11 Scan bodies prior to intraoral digital impression.Figure 8.4.12 (A, B) STL file from intraoral digital impression.Figure 8.4.13 CAD design of final crowns after superimposition of the three ...Figure 8.4.14 Definitive crowns delivery (frontal view).Figure 8.4.15 Radiograph.Figure 8.4.16 Smile.Figure 8.4.17 Clinical outcome after one year.

      43 Chapter 8.5Figure 8.5.1 Initial pre‐orthodontics presentation.Figure 8.5.2 Final teeth position presentation prior to orthodontics debondi...Figure 8.5.3 Probing pocket depth measurements during the initial preoperati...Figure 8.5.4 Initial panoramic radiograph (post orthodontics).Figure 8.5.5 Implant placement with simultaneous bone grafting for tooth #7....Figure 8.5.6 (A, B) After three‐month healing period of implant placement at...Figure 8.5.7 Veneer preparations for teeth #6, #8, #9 and #11. A PVS key is ...Figure 8.5.8 Final impression of veneer‐prepared teeth #6, #8, #9, and #11 ...Figure 8.5.9 Porcelain veneers and implant restorations on the master cast....Figure 8.5.10 (A, B) Postoperative frontal and occlusal views.Figure 8.5.11 Preoperative (A) and postoperative (B) comparison of smile.

      44 Chapter 9.1Figure 9.1.1 Initial presentation on examination.Figure 9.1.2 One year following plaque control instruction and scaling and r...Figure 9.1.3 Probing pocket depth measurements.Figure 9.1.4 (A–C) Periapical preoperative radiographs depicting the interpr...Figure 9.1.5 (A, B) Periapical postoperative radiographs depicting the inter...Figure 9.1.6 A variety of methods for plaque removal by the patient: (A) Bas...

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      1  Cover Page

      2  Series Page

      3  Title Page

      4  Copyright Page

      5  Dedication Page

      6  Contributors

      7  Preface

      8  About the Companion Website

      9  Table of Contents

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      11  Index

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