During implant placement unexpected alveolar defects are common. The following case outlines the use of a quick, simple and inexpensive solution to this common problem. Radiographic images identified a radioleucency in the area of a previous bicuspid extraction. It was assumed that inadequate ossification had followed the extraction and bone grafting may be needed. Also, the crestal ridge width was minimal and it was assumed that the coronal portion of the implant bone may perforate the buccal and lingual bone.

Photo of lower left ridge identifying a significant pathologic defect in the area of #20.




Alveolar ridge with exposed lesion and narrow posterior ridge




The lesion removed




Implants placed after irrigating the sockets with HYDRASE




Due to the lesion in the area of implant #20 only a small portion of the implant will properly integrate. Also the buccal portion of implants 18 and 19 have exposed buccal surfaces. A combination of low density hydroxylapatite (LDHA) and REGEN BIOCEMENT wetted with HYDRASE was applied to regenerate integrated bone over the exposed implant surfaces. This photo demonstrates the firm body of the graft material showing LDHA in a matrix of REGEN BIOCEMENT. Primary closure with the implant caps exposed was used without use of a membrane. REGEN BIOCEMENT bonds to the implant surface preventing contact with either soft connective tissue or epithelium. LDHA serves as a filler to hold the tissue volume until ossification is complete. HYDRASE provide the ideal physiologic environment for bone growth to convert the graft to functional bone.




Two year post operative radiograph