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    • The In-Between Implant

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    • 1. The patient presented with severe peri-implantitis around 2 central incisors zirconia implants
    • 2. The patient presented with severe peri-implantitis around 2 central incisors zirconia implants
    • 3. The old crowns were removed, and a provisional bridge was fabricated with a new design proposal. Pink composite was added to have a clear idea of the incisal edge position/toothform and artificial gingival replacement
    • 4. The old crowns were removed, and a provisional bridge was fabricated with a new design proposal. Pink composite was added to have a clear idea of the incisal edge position/toothform and artificial gingival replacement
    • 5. Superimposing the STL file and the Dicom files in the planning software (MSoft/MIS) allowed us to plan the exact position of the new implant
    • 6. Superimposing the STL file and the Dicom files in the planning software (MSoft/MIS) allowed us to plan the exact position of the new implant
    • 7. Superimposing the STL file and the Dicom files in the planning software (MSoft/MIS) allowed us to plan the exact position of the new implant
    • 8. Considerable bone loss around the existing implants and mesially to the lateral incisors: the two implants were removed
    • 9. Considerable bone loss around the existing implants and mesially to the lateral incisors: the two implants were removed
    • 10. Occlusal view after implant removal: the ridge was surgically corrected and flattened after implant removal. The implant will be placed in a more palatal and “in between” position compared to the extraction sockets to get excellent primary stability for immediate loading
    • 11. Placement of the implant (V3/ RP 3,9 mm - 13 mm) using the MGuide (MIS). The palatal position for obtaining a screw retained restoration is the key point in this specific case
    • 12. After placement of a provisional cylinder, OsteoBiol® GTO® was placed and packed, with the instruments and around the implant in order to support the soft tissue
    • 13. After placement of a provisional cylinder, OsteoBiol® GTO® was placed and packed, with the instruments and around the implant in order to support the soft tissue
    • 14. After placement of a provisional cylinder, OsteoBiol® GTO® was placed and packed, with the instruments and around the implant in order to support the soft tissue
    • 15. After making the final preparation of tooth #22, a digital impression was taken with a scanpost (MIS)
    • 16. Occlusal view after 4 months. Please note the excellent soft tissue health and three-dimensional stability of the residual ridge after grafting
    • 17. A 2-unit screw retained zirconia bridge (#11 and #21) and a single crown (tooth #22) were milled and layered
    • 18. Final clinical result. Note the integration and gingival health
    • 19. Final X-Ray. Note stable marginal bone levels around the implant and the nice integration of the graft (OsteoBiol® GTO®) in the peri-implant space
    • Clinical indication: alveolar regeneration
    • Products : GTO®
    • Authors : Dr. Eric Van Dooren
    • Information about patient: Female, 46 years old
    • Credits : Documentation provided by Dr. Eric Van Dooren, Antwerp, Belgium
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