Combined application of roll flap and combination onlay-interpositional graft to enhance esthetics of maxillary anterior fixed partial denture: A case report

In the maxillary anterior region, reconstruction of the localized alveolar ridge defect is very important in enhancing the esthetics of fixed partial denture. A 40-year-old female patient presented with a chief complaint of the inconvenience and unesthetic problem of 3-unit maxillary anterior prosthesis due to alveolar ridge resorption. After removal of old prosthesis, intraoral examination revealed moderate (buccolingually 4 mm) ridge deficiency in missing tooth region, leading to the diagnosis of Class I alveolar ridge defect. One of the reconstruction techniques to overcome this problem might be a technique that combines two types of soft tissue augmentation techniques. The purpose of this paper was to demonstrate the new combined technique of roll flap and combination onlay-interpositional graft utilized to acquire sufficient dimension of recipient area by one time of operation and to present the esthetic improvement of fixed partial denture by using this procedure in case of maxillary anterior localized ridge defect.

Supplement the Base to Complement the Crown: Localized Ridge Augmentation using Connective Tissue Graft.

Interdisciplinary approach should be contemplated as a long term solution for esthetic and functional dental rehabilitation of patients. To obtain longevity of treatment, the therapeutic decisions must be based on a strong periodontal foundation. To prevent unacceptable esthetic deformities due to lost oral tissues, a plethora of treatment modalities are available, to augment the alveolar ridge, and to improve the esthetic outcome of the final prosthesis. Prior to the replacement of missing teeth, esthetic, and physiologic corrections of edentulous areas are critical pre‑requisites. This article describes a surgical procedure to enhance a localized buccal ridge defect and create an emergence profile in relation to the maxillary left central incisor region, prior to the construction of a fixed partial denture using a connective tissue graft.

Localized ridge defect augmentation using human pericardium membrane and demineralized bone matrix.

Background: Patient wanted to restore her lost teeth with implants in the lower left first molar and second premolar region. Cone beam computerized tomography (CBCT) revealed inadequate bone width and height around future implant sites. The extraction socket of second premolar area revealed inadequate socket healing with sparse bone fill after 4 months of extraction. Aim: To evaluate the clinical feasibility of using a collagen physical resorbable barrier made of human pericardium (HP) to augment localized alveolar ridge defects for the subsequent placement of dental implants. Materials and Methods: Ridge augmentation was done in the compromised area using Puros® demineralized bone matrix (DBM) Putty with chips and an HP allograft membrane. Horizontal (width) and vertical hard tissue measurements with CBCT were recorded on the day of ridge augmentation surgery, 4 month and 7 months follow‑up. Intra oral periapical taken 1 year after implant installation showed minimal crestal bone loss. Results: Bone volume achieved through guided bone regeneration was a gain of 4.8 mm horizontally (width) and 6.8 mm vertically in the deficient ridge within a period of 7 months following the procedure. Conclusion and Clinical Implications: The results suggested that HP Allograft membrane may be a suitable component for augmentation of localized alveolar ridge defects in conjunction with DBM with bone chips.