Clinical case description:
This patient presents an agenesis of 9 teeth. After 3 years of orthodontic treatment, we decide to put an implants with crowns. The cone beam shows an inclination of the crest which is unfavorable for a good prosthetic reconstruction (risk of fracture). We decided to make a GBR to improve the axis of the implant. The treatment plan is: 1. GBR. 2. Implant placement (6 month). The GBR technique described by Smukler in 2008 consists in harvesting local bone with a trephine, using a fixed cast Geistlich Bio-Gide® membrane with tacks, filling the hole with Geistlich Bio-Oss®, stabilizing the membrane over the autogenous bone at the level of the grafted site. Suture are realized to fix the membrane at the level of the palate to stabilized the graft. A control radiograph showed at 6 months enough bone augmentation to place the implant with the right axis. The prosthetic restoration was finalized 3 months after implant surgery. After 3 years, the result seems stable.