Implant Placement Surgery at #11 and #21 with Ridge Split and Bone Grafting
Surgical Procedure
Chief Complaint
Patient presented for replacement of missing upper anterior teeth #11 and #21 and wished to restore function and aesthetics in the anterior region.
Clinical Findings
Missing teeth at #11 and #21.
CBCT reviewed for assessment of ridge width, bone volume, and anatomical structures including the nasopalatine nerve.
Narrow alveolar ridge noted, requiring ridge expansion prior to implant placement.
Sites suitable for implant placement with ridge split and bone grafting support.
Treatment Plan
Implant placement at #11 and #21 using narrow-diameter implants.
Ridge split procedure to expand alveolar ridge width.
Fenestration preparation to promote bone regeneration.
Bone grafting using artificial bone graft material to enhance implant support and contour.
Healing abutment placement for soft tissue shaping.
Labial frenum release to improve soft tissue adaptation and stability.
Pre-operative Assessment
CBCT reviewed and implant positions planned.
Risks and procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained for implant placement at #11 and #21.
Pre-operative photographs taken.
Anesthesia
Local anaesthesia administered.
Surgical Procedure
Patient cleaned and draped under sterile conditions.
Incision made and buccal flap raised.
Ridge split performed using chisel and mallet to expand the alveolar ridge.
Implant osteotomies prepared with implant drills and osteotomes.
Megagen Anyone Mini Implants (3.0 mm × 13.0 mm) prepared with Megagen Plasma Blast and placed at sites #11 and #21.
Healing abutments placed:
#21: MEGAGEN Healing Abutment [MN] O3/H = 7
#11: MEGAGEN Healing Abutment [MN] O3/H = 4
Fenestrations created using a round slow-speed TC bur around implant sites to encourage bone regeneration.
Bone grafting performed using Dentium Osteon Collagen II artificial bone graft material (2 packs).
Flap released and stabilized with 5/0 resorbable sutures ×7 for primary closure.
Labial frenum released and secured with additional 5/0 resorbable sutures ×4.
Hemostasis achieved and post-operative instructions provided.
Post-operative Assessment
Post-operative CBCT taken.
Nasopalatine nerve not involved.
Implant alignment and positioning satisfactory.
Bone graft density satisfactory.
Primary closure stable.
Pre- and post-operative photographs taken.
Patient satisfied with surgical outcome.