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Follow up on an earlier salvage attempt on crestal bone loss: thoughts?

Last Updated: May 11, 2015

This is a year follow up on a case that was posted earlier, as Can one salvage a crestal bone loss case? (Editor’s Note: Please follow the case link above to read the original case and comments) .

The grafted bone seems to have attained some mineralization and also is fusing with the native bone but perhaps, not with the implant. What are you thoughts on this?

![]Periapical film, 1 year post GBR](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/05/20150506_114303-e1431351155983.jpg)Periapical film, 1 year post GBRAdditional pictures:

![]Healing abutments at second stage just before impression taking](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/05/20141111_113942.jpg)Healing abutments at second stage just before impression taking
![]Removal of healing abutments](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/05/20141111_114224.jpg)Removal of healing abutments
![]Torquing of solid abutments](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/05/20141111_120458.jpg)Torquing of solid abutments
![]Impression baskets in place](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/05/20141111_120006.jpg)Impression baskets in place

10 Comments on Follow up on an earlier salvage attempt on crestal bone loss: thoughts?

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PeterFairbairn

5/11/2015

Looks not to bad an outcome as this can be difficult what did you do in the end ? graft wise .

CRS

5/12/2015

Looks like a very nice result. Are those crowns splinted? why?

A Aslam OMS

5/12/2015

Thank you. FDBA with Pericardium membrane (Lyoplant) It was the Prosthodontists' call and restorative plan. Guess at the time of loading about 8 months ago, they didn't believe much in the salvage attempt

Tuss

5/13/2015

Hi, speaking as a prostho we always have to have a fall back option so if the middle implant failed the 3 splinted crowns could be converted to a 3-unit bridge with ease

AAslamOMS

5/13/2015

Another thing. The patient is a known bruxist. Probably another consideration our Prostho guys undertook

Tuss

5/14/2015

he does look like a heavy bruxer and by the look of things he probably has no anterior guidance and may be in group function - if thats the case then those implants will be hammered in the coming years so re-establishing anterior guidance now (or fitting a bruxing hard acrylic appliance) would be smart

Tuss

5/14/2015

there do seem to be bony changes at the neck of the centre implant, the fit of the bridge is not ideal so if you do get plaque build up in conjunction with the parafunction then life will become very interesting

CRS

5/15/2015

Splinted but cleansable with great spacing and connective tissue. I learned a lot from the posts! Love those prosto guys, I just enjoy working with them since they are smarter than me!

Jaime Ramos

5/19/2015

I think that this case will be succesfull , good spacing ( unaesthetic region ) and good keratinized epithelium . Crown adaptation could be better ! We have a 2- dimensional image ??

greg steiner

5/29/2015

A Aslam Your evaluation of lack of implant support by the graft material is correct. Allografts placed against an implant never integrates to the implant surface no matter if it is a repair or around an immediate implant. Greg Steiner Steiner Biotechnology

most favorable place for drilling the osteotomy site more effective maxillary restoration