Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva

01/20 - Initial situation - broken and missing upper right central incisor (UR1). This tooth was removed long time ago and there were signs of bone loss and resorption due to the bone remodelling. Patient was also undergoing orthodontic treatment due to the loss of mesio-distal space.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
02/20 - Guided bone regeneration after implant placement using Jason® membrane with good pin stabilisation.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
03/20 - Exposed implant threads covered with a thin layer of autogenous bone chips harvested during implant bed preparation.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
04/20 - Bone volume augmentation was conducted with maxgraft® (<2 mm mm of 0.5 cc) mixed with cerabone® (0.5- 1.0 mm) 4:1 shaped to create convexity.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
05/20 - Stabilisation of Jason® membrane using additional titanium pins.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
06/20 - Grafting site was covered by two mucoderm® (15x20mm) used as a soft tissue graft as well as a membrane over Jason® membrane . mucoderm® was stabilised with sutures on each side.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
07/20 - Modified sling suture used to stabilise mucoderm® .

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
08/20 - Wound closure without tension and without having to make extra incisions.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
09/20 - Wound closure without tension and without having to make extra incisions.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
10/20 - Healing stage 8 weeks after surgery - healing abutment partly exposed. Sutures were removed 2 weeks after implant and bone graft surgery.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
11/20 - Healing stage 8 weeks after surgery - healing abutment partly exposed.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
12/20 - First impression stage for temporary screw retained implant crown 16 weeks after surgery.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
13/20 - Fit of the temporary screw retained implant bridge 18 weeks after implant placement surgery.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
14/20 - Gingival zenith and soft tissue contour 5 weeks with the temporary crown.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
15/20 - Gingival zenith and soft tissue contour 5 weeks with the temporary crown.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
16/20 - Final result 3 months after surgery and 2 weeks after final prosthetic integration.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
17/20 - Final result 3 months after surgery and 2 weeks after final prosthetic integration.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
18/20 - Smile line and harmonisation of white and pink aesthetic.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
19/20 - Smile line and harmonisation of white and pink aesthetic.

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva
20/20 - Two Years follow up

Delayed implant placement with GBR and soft tissue augmentation at the aesthetic area - 2 years follow up – Dr. H. Maghaireh & Dr. V. Ivancheva