Dr. Tamás Székely

Clinical Situation:

A patient presented seeking replacement of the missing maxillary central incisors with implant-supported restorations. The patient specifically declined a fixed bridge and requested a fully implant-based solution.

Clinical examination revealed a severely resorbed, narrow anterior maxillary ridge resulting from delayed tooth extractions. The available horizontal bone volume was insufficient for prosthetically driven implant placement, making ridge augmentation necessary before implant insertion.

Treatment Objectives

• Reconstruct the horizontal width of the anterior maxillary ridge.
• Create sufficient bone volume for ideal implant positioning.
• Preserve soft tissue architecture.
• Achieve an aesthetic implant-supported rehabilitation.

Surgical Procedure

A full-thickness mucoperiosteal flap was elevated, exposing the deficient alveolar ridge.

Following cortical bone preparation, NOVAMag^® membrane was adapted and stabilized using NOVAMag^® fixation screw, creating a stable regenerative compartment.

The defect was then grafted with cerabone^® (0.5–1.0 mm) to reconstruct the horizontal ridge contour.

The flap was repositioned and sutured to achieve tension-free primary closure.

Healing Phase

After 6 months of uneventful healing, the augmented ridge demonstrated substantial horizontal bone gain with excellent volume stability.

The regenerated ridge allowed straightforward placement of two dental implants in ideal prosthetic positions.

Following an additional 3 months of osseointegration, customized individual healing abutments were placed to shape the peri-implant soft tissues and establish a natural emergence profile before the definitive restorations.

Outcome

• Predictable horizontal ridge augmentation achieved.
• Excellent ridge width gained for implant placement.
• Stable regenerated bone after healing.
• Successful placement of two implants in the esthetic zone.
• Healthy peri-implant soft tissues with favorable emergence profile.