Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants

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This case involves a patient that presented with a fractured tooth #12, and missing #13. #12 was deemed non-restorable due to the extent of the fracture. The treatment plan was extraction of #12 followed by an implant, and then placement of an implant in missing tooth #13. The radiograph showed 2 challenges with this case: firstly, the presence of a unique odontoma, and secondly the presence of a periapical radiolucency above #12. Following tooth extraction and removal of the odontoma, an osteotomy was prepared and 2 Keystone Paltop Implants were placed. Following placement, GBR was performed, using DALI Mineralized Cortical Cancellous Allograft covered with OsseoSeal. At 3 months post-op, the patient returned and all vital signs were checked and deemed satisfactory. The result was very nice, including beautiful formation of peri-implant tissue.

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Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 1

Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 2

Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 3

Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 4

Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 5

Trusting the Process: Removal of Odontoma, GBR, and Placement of Keystone Paltop Implants 6

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timcarter comments:

Excellent case and for the sake of educating the folks on this forum could you please explain your reason for using a membrane in addition to the particulate graft. I understand that it is extremely common to do so and I am not saying it is wrong though IMHO it is not necessary and could result in excess fees for the patient. Since the actual defect/exposed threads are contained within boney walls and the graft on 13 is purely for contour I would opt to not use a membrane. I repeat that I am not saying that it is wrong to do so just not necessary and I would like to start a discussion on the reason for such.....