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Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli
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1/12 - Initial view of the clinical case: Class III malocclusion Treatment plan: Regenerative corticotomy (PAOO)
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
2/12 - Pre-op x-ray reveals skeletal class III.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
3/12 - Dehiscence defect and thin buccal plate.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
4/12 - PAOO protocol includes a surgical preperation of the cortical bone which can be performed with rotary instruments or piezo-electric scalpels.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
5/12 - A layer of cerabone® applied -as reliable and volume stable bone substitute.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
6/12 - mucoderm® acting as a barrier membrane and as a soft tissue graft. The combination of hard and soft tissue grafting increases the bone regeneration and the soft tissue thickness. Thus, enhancing the clinical outcome.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
7/12 - Primary closure of the area is ensured by coronally positioning the flap. Mobilization of the flap is obtained undermining the periostium at the base of the flap.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
8/12 - Two weeks post-op showing excellent augmentation of the area and some minor marginal gingival inflammation.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
9/12 - Frontal view: Before and after orthodontics, orthognatic surgery and periodontal therapy with the regenerative corticotomy. Repaired recessions and increased thickness of gingiva.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
10/12 - Lateral pre-op and post-op view: Evident change in position of the incisors and the augmented vestibular periodontium.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
11/12 - Pre and post-op x-ray reveals counter-clock rotation of the mandibula due to the orthognatic surgery and the vestibular inclination of the incisors due to the orthodontic treatment.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli -
12/12 - Pre and post-op CT showing a great bone volume gain in the lower frontal area. Confirming the augmentation of not only the soft tissue, but also of the hard tissue components.
Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm® - Dr. F. Brugnami & Dr. S. Meuli
Pre-op picture of affected teeth 11 and 21
Extraction of tooth 21 after endodontic treatment
Three implants placed in a narrow posterior mandible
Clinical view 8 weeks after extraction of teeth 25 and 26
Initial situation: missing teeth #11 & 12 and badly broken #21 root
Instable bridge situation with abscess formation at tooth #15 after apicoectomy
Initial clinical situation with broken bridge abutment in regio 12 and tooth 21 not worth preserving
Initial situation - endodontically failing tooth 22, very thin biotype, high lip line and esthetic expectations
The patient presented with severe pain in the lateral incisor and a deficient adhesive provisional. Bruxism resulted in canine loss and premature contact in the lateral incisor.
Lateral view of the defect in the posterior right maxilla.
Initial x-ray showing bone loss around implants placed 5 years ago in another dental clinic
Initial clinical situation with gum recession and labial bone loss eight weeks following tooth extraction
Atrophic alveolar ridge in the left mandible
Pre-operative: loss of interdental papilla between 12 and 11 associated with gingival inflammation and pus
Clinical situation at baseline: Situation after tooth extraction UR1 due to a failed endodontic treatment 3 months previously
