3-dimensional reconstruction of the alveolar ridge

The 3D optical reconstruction of the CBCT pictures shows the extend of bone loss in the maxilla. The atrophy in the posterior mandible is also evident but not treated at this time point.

Vertical and horizontal bone augmentation with calvarial onlay block grafts. The grafts were positioned exactly along the atrophied maxillary contour. Block grafts were rigidly fixed with titanium micro screws. Autologous bone chips were placed at the transition zones to promote good bone remodeling.

Prior to primary wound closure, the augmented maxilla was covered with Geistlich Geistlich Bio-Gide^® membrane.

Postoperative clinical picture one week after suture removal shows complication-free healing.

Planning of the prosthetic rehabilitation in the digital optical model (frontal view).

Planning of the prosthetic rehabilitation including implant positions in the digital optical model (lateral view).

Situation at re-opening 5 months after augmentation showing good incorporation of the graft.

Intraoperative situation after removal of the osteosynthesis screws and placement of 6 implants (Astra Tech implants, diameter 4.5 mm).

Panoramic radiograph after implant placement.

Clinical picture at time point of abutment connection. The implants were left 4 months for submerged healing.

Clinical situation before fixation of the final prosthesis.

Clinical situation with final restoration. The removable prosthetic restoration is retained by a CAD/CAM bar.