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Guided Bone Regeneration in Dental Implant Treatment - a Case Report

By Pavel Kobler, Jasenka Živko-Babić and Josipa Borčić

Abstract

Gubitak prednjih zuba posljedica je patoloških procesa, retenecije zuba (najčešće gornjeg očnjaka), posljedica traume (avulzija ili fraktura korijena) ili nedostatka zubnoga zametka (najčešće gornjega drugog sjekutića). Takvi slučajevi mogu se riješavati ortodontski (zatvaranjem nastaloga prostora), protetski (različitim mostnim konstrukcijama) ili implantoprotetskom rehabilitacijom. Nedostatak ortodontske terapije dugotrajna je rehabilitacija i česti estetski nedostatci.Kod mostne konstrukcije moraju se odstraniti tvrda zubna tkiva susjednih zuba, a dijasteme su kontraindikacija za njihovu primjenu. Usadci omogućuju izradbu samostalnih žvačnih jedinica, ali je preduvjet dovoljno kosti za primarnu stabilizaciju i dugotrajnost usadka. Kada postoji manjak kosti, koristimo se vođenom koštanom regeneracijom (VKR). VKR dokazana je metoda koštane regeneracije, a uporaba kolagenih membrana znatno povećava učinkovitost opisanoga postupka. Dvadesetsedmogodišnjoj pacijentici operacijom je izvađen prvi gornji sjekutić zbog upalnoga procesa i resorptivnih promjena na kosti kao posljedice uzdužne frakture korijena. Neposredno nakon ekstrakcije kohleacijom je odstranjeno granulacijsko tkivo, koštani defekt ispunjen je Bio-Oss spongioznim granulama, a operacijsko polje pokriveno je Bio-Gide resorptivnom membranom. Godinu dana nakon operacije nastala je koštana regeneracija i ugrađen je ITI Straumannov implantat duljine 12 mm i promjera 3,3 mm. Zbog djelomične bukalne dehiscencije upotrijebljen je Fiziograft. Nakon 6 mjeseci izrađen je fiksnoprotetski nadomjestak.Loss of anterior teeth can be caused by pathological processes, tooth retention (mostly upper canine), result of trauma (avulsion or root fracture) or missing tooth germ. Such defects can be solved by orthodontic treatment (orthodontic space closure), prosthetic treatment (different bridge constructions) or with surgery treatment (dental implants). Inadequancy of orthodontic therapy is long lasting rehabilitation ond mostly esthetical imperfection. At the bridge constructions, hard tissues of adjacent teeth must be removed. Another contraindication is the presence of diastemas. Dental implants enable making selfsupporting mastication units, but require sufficient bone to adequately stabilise. When there are changes in alveolar bone height and width, we use guided bone regeneration (GBR). GBR has proved to be a suitable technique for promoting bone regeneration. GBR treatment with collagen membranes may significantly enhance bone regeneration. The left first incisor of a 27 years old patient was extracted because of resorptive processes on alveolar bone as a result of longitudinal fracture of the root. Immediately after extraction, the bone defect was filled with Bio-Oss spongiosa granules and covered with Bio-Gide resorbable bilayer mambrane. After one year the defect was restored to nearly original condition and ITI Straumann implant was placed. Because of labial dehiscence Fisiograft was used. The definitive restoration was placed after 6 months

Publisher: School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Year: 2003
OAI identifier: oai:hrcak.srce.hr:3402

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