Three month after the extraction of a lateral incisor Professor Dr. Marc Hürzeler, Munich/Germany, demonstrates the delayed insertion of an implant. In the esthetic zone the procedure has to be performed with special care. Three month after the extraction of a lateral incisor and the coverage of the wound with a gingiva patch the delayed insertion of an implant is demonstrated. Clinically, thick scar tissue is present in the apical region of the lateral incisor indicating several attempts of an apicoectomy. As a consequence, an extended bone defect in the buccal area is expected, also based on the preoperative diagnosis including a three dimensional CT image. Therefore, along with the delayed implantation the hard tissue augmentation in this area is carried out and demonstrated within the surgery.

The implantation is conducted using a navigation template which allows for optimal drilling conditions with respect to the prior determined implant position, alignment and depth. Despite the broad expanse of the bone defect sufficient implant stability can be reached. The autologous bone chips harvested from the spina nasalis area are inserted into the defect onto the implant and covered with a layer of bone substitute. The defect shape with bone structures left like “embracing arms“ is positive for a successful regeneration. Finally, a membrane is placed on top and the wound closed with a special suturing technique.