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A 51-year-old woman lost the teeth #6 and 7 due to odontoma removal ~30 years ago. The area was restored with a FPD. The latter is removed with immediate implant at #8 8-9 months earlier. Particulate bone graft does not repair the bone deficiency at #6, 7 (Fig.2,3), although the soft tissue looks bulky (Fig.1).
Make buccal and palatal sulcus incisions with 2 accessory incisions from #3 mesial to 10 distal. Elevate the periosteum until the nasal floor. Place Vanilla and 6 month membrane over #5 root and #8 exposed implant threads and 2 pieces of chin graft at #6 and 7 buccal and palatal (sandwich). Use bone screws for fixation.
Xin Wei, DDS, PhD, MS 1st edition 05/28/2018, last revision 07/20/2018