Sinus graft complications & management

The following clinical case shows several minor complications and management during different dental implant surgical stages. 

This is the case of a  28 years old healthy male who came to our clinic for dental implant rehabilitation of the posterior left maxillary area. After clinical and radiographic evaluation, the need for vertical and horizontal ridge bone augmentation was determined. Vertical augmentation was treatment planned to be obtained through lateral window sinus lift surgery accompanied by horizontal ridge augmentation using particulate bone grafting material and membrane. 

Two dental implants were placed 8 months post sinus lift surgery. During the osteotomy for the molar site implant, a small membrane perforation was identified, managed and controlled through the osteotomy site. Dental implants were placed and primary stability was obtained for both. 

Upon dental implant uncovery, 3 months after surgical placement,  bone loss was found on the molar site implant. We reduced the exposed implant threads with Implant-plasty using a fine diamond bur and a layer of HA xenograft bone grafting material was used to graft the facial aspect of the implant. 

The 3 year follow up X-ray shows good bone stability around the implants.

Ioannis

Gingival recession treatment with connective tissue graft

Patient presented to our clinic with the chief complaint of: "Increased and persistent sensitivity on upper left central, lateral, canine and first premolar teeth (21, 22, 23, 24)"

After clinical and radiographic evaluation our Diagnosis given to those teeth was: Class I Miller recession on 21, 22, 23, 24

Etiology: Traumatic forces (applied with a hard toothbrush) over a thin tissue biotype.

Treatment plan: Connective tissue graft with a coronally positioned flap

Prognosis: Excellent (90-100% root coverage is anticipated in class I miller recessions)

Some post operative instructions given to the patient included but were not limited to: 

- Oral hygiene modification: modified Bass toothbrusing technique was instructed

- Recommended the use of a soft toothbrush 

Ioannis

Excision of a Fibroma with the use of a Nd-Yag Laser

Clinical diagnosis:
- Trauma induced Fibroma

Treatment protocol:
1. Occlusal adjustment of the uneven cusps of the teeth involved
2. Complete excision of the lesion for histologic evaluation

The excision of the lesion was performed using a Nd-Yag Laser.
Settings used: 4W, 200mJ, 20Hz