Clinical case description:

Treatment of a patient with a complex vertical and horizontal bone defect across an edentulous area in the maxilla caused by a facial trauma due to a traffic accident: Successful reconstruction of the bone volume using a customized 3-D titanium scaffold (Yxoss CBR^®) followed by placement of three implants according to the prosthetic project.

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Clinical case description:

Case of a partially edentulous patient with a severe horizontal and vertical bone atrophy of the left mandible. Solution in two steps: first, reconstruction of the bone with a customized 3-D titanium scaffold (Yxoss CBR^®) to restore the ideal anatomy; second, prosthetically guided placement of 3 implants.

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Questions regarding the treatment concept? Contact directly the surgeon through THE BOX Gian Maria Ragucci
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Clinical case description:

The patient has a root fracture at tooth 11 and due to the root micro movement in the alveolar ridge together with the periodontal bacterial infiltration, the buccal bone was resorbed (type 2 class). Tooth 11 was extracted atraumatically and the socket preservation procedure was performed in accordance with the open-healing protocol. The final outcome was stable, from both functional and esthetic points of view, reinforcing the biological advantages using the open-healing technique followed by fl apless tissue level implants in the esthetic zone.

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Clinical case description:

3.5-year follow-up by Dr. Paul Stone / 9.5-year follow-up by Dr. Christian Ramel / 4 and 5.5-year follow-up by Dr. Claude Andreoni and Dr. Thomas Meier / 10-year follow-up by Dr. Jean-Pierre Gardella (surgeon) and Dr. Christian Richelme (prosthodontist) / 12-year follow-up by Prof. Daniel Buser and Prof. Urs Belser

Clinical case description:

Root coverage at multiple gingival recessions with coronally advanced flap and Geistlich Fibro-Gide^®

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Clinical case description:

Orthodontic treatment had to be postponed due to periodontal disease. Patient with thin biotype and a gummy smile with high expectations. The use of the "Buccal Pedicle Flap" and Geistlich Fibro-Gide(R) allowed to boost the peri-implant mucosa with a minimally invasive approach.

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Clinical case description:

This case demonstrates late implant placement in the posterior mandible facilitated by horizontal and vertical bone regeneration with a customized 3-D titanium scaffold (Yxoss CBR^®). To create a stable periimplant soft tissue and thus ensure long-term implant preservation, this treatment also required soft tissue thickening using Geistlich Fibro-Gide® and a subsequent vestibuloplasty for keratinized tissue gain using Geistlich Mucograft^®.

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Clinical case description:

Patient was interested in replacing her missing tooth with a dental implant, and was wearing a Nesbit appliance. The irritation from the ill-fitting Nesbit appliance resulted in irregular and friable soft-tissue at site #9. The treatment goal was to regain the horizontal dimension of hard and soft-tissue through guided bone regeneration. Adequate hard and soft-tissue architecture was restored with the use of Geistlich Bio-Oss^® and Geistlich Bio-Gide^® for predictable, prosthetically-driven implant placement.

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Clinical case description:

A patient with a progressive gum recession which had led to compromised esthetics and sensitivity. The teeth had 3-4 mm of gingival recession on the buccal surface with a sufficient zone of

keratinized gingiva. The patients' main priorities were to improve

esthetics and reduce/eliminate root sensitivity. Treatment goals for this case were to obtain complete root coverage, increase soft-tissue thickness, and reduce/eliminate cervical sensitivity. Using Geistlich Fibro-Gide^® a 100% root coverage has been obtained

and the patients' chief complaints of esthetics and sensitivity have been addressed.

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Clinical case description:

The case here is typical enough, a failing mandibular molar with a vertical sub-osseous fracture. Immediate molar replacement requires atraumatic removal of the fractured tooth, careful socket debridement and development of a channel for an ideally positioned implant.

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Clinical case description:

Multiple buccal recession defects ranging 2-5 mm were noted by teeth #11-14 with a minimal amount of keratinized tissue on the buccal of #14. Bone levels were within normal limits with no loss of interproximal tissue observed. These recession defects are classified as Miller Class I recession defects. Typically, 100% root coverage is expected for recession defects of this type. The treatment was complete root coverage of the recession defects and augmentation of the width of attached keratinized tissue by tooth #14. Complete root coverage and an increase in the zone of keratinized tissue was obtained and a dento-gingival complex that is amenable to long-term health and stability was achieved. The patient was spared from the inevitable morbidities associated with a sub-epithelial connective tissue graft from a palatal donor site.

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Clinical case description:

This case presents a fracture of tooth #19 which is the distal abutment for a four unit bridge tooth #19-22, with pontics in the #20 and #21 positions. The patient wanted a implant restoration at positions #19, #20 and #21 and thus, lateral ridge augmentation with autogenous bone and Geistlich Bio-Oss® and Geistlich Bio-Gide® was performed.

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Clinical case description:

3-D bone augmentation using a CAD/CAM customized titanium mesh in conjunction with autogenous bone and bovine bone mineral granules

A 75-year old and systemically healthy female came to our attention requiring a fixed rehabilitation in the bilateral mandibular edentulous areas, from teeth 35 to 38 and from 45 to 48. The clinical and radiological evaluation showed vertical and horizontal bone atrophies. Based on a computed tomography of the defect (CBCT) carried out before the surgical procedure with the aid of a radiopaque diagnostic template, DICOM scans of the three-dimensional models are reproduced in a very precise way. This makes it possible to produce a precise and accurate three-dimensional titanium scaffold which on its outer part represents the final shape/profile of the new and ideal alveolar ridge, while in the inner part containing and stabilizing the grafting material. This latter is generally represented by a mixture of autogenous bone chips and bovine bone mineral. The mesh was covered with a Geistlich Bio-Gide^® in order to optimize the barrier effect.

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Questions regarding the treatment concept? Contact directly the surgeon through THE BOX Matteo Chiapasco & THE BOX Grazia Tommasato
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Clinical case description:

Ramal Bone Graft for Congenitally Missing Maxillary Lateral Incisor

This is a young patient with a congenitally missing incisor that has high aesthetic concerns and has had multiple failed surgical attempts. The goals for this patient are to reconstruct the osseous foundation and provide a matrix for improvement with the overlying soft-tissue. There has been significant gain in bony architecture and development of soft-tissue contours at a site that was extremely deficient of structure to begin with. Goal was to identify the problem, establish a sequenced plan and execute with equal attention to hard and soft-tissue augmentation and manipulation.

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Clinical case description:

L-Shape Technique as a means of bone augmentation together with early implant placement

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Questions regarding the treatment concept? Contact directly the surgeon through THE BOX Ronald E. Jung, THE BOX Tobias Basler & THE BOX Alfonso Gil
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Clinical case description:

Soft-tissue augmentation in the esthetic zone

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