Dr. Sebastián Bravo

A 70-year-old patient presented with a large odontogenic cyst involving teeth #8 and #9 in the esthetic zone. Given the importance of preserving the natural dentition whenever biologically feasible, a conservative surgical approach was selected instead of extraction and implant placement.

The primary clinical challenge was the management of an extensive periapical lesion while maintaining the integrity of the gingival architecture and avoiding esthetic complications such as scarring or soft tissue recession.

Surgical access was achieved using the Esthetic Buccal Flap (EBF) technique, allowing complete apical access while preserving the gingival margins intact. Following cyst enucleation and apicoectomy, three-dimensional Guided Bone Regeneration (GBR) was performed using maxgraft^® allogeneic bone graft material in combination with the porcine collagen Jason^® membrane to stabilize and protect the regenerative site.

Clinical and radiographic evaluation at the 3-year follow-up already demonstrated excellent healing and significant regeneration of the buccal cortical plate, with stable soft tissue architecture and favorable esthetic integration.

CBCT and clinical evaluation at the 6-year follow-up confirmed the long-term stability of the regenerative outcome, showing stable bone levels, excellent soft tissue integration, absence of gingival recession or visible scarring, and full preservation of the natural teeth in function.

This case highlights how the combination of evidence-based surgical protocols with predictable biomaterials such as maxgraft^® and Jason^® membrane can achieve long-term functional and esthetic success while preserving the patient’s natural dentition.