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Soft Tissues Grafting Gallery

Below You can see images of soft tissue grafting from the patients palate to the extraction socket area and preservation of the extraction socket for implant placement.

Please note the photos below contain images of blood and surgery, so please change the page if you dont wish to see such images

Case 10 (Soft Tissue Grafting & Socket Preservation)

Soft Tissues Grafting Before After - Upper tooth ill crown fitting/ root decayThis patient suffered from recurrent loss of his upper right front crown. The crown was ill fitting and the root was decayed and had fractured and as a result, the crown kept debonding.
Soft Tissues Grafting Before After - Asymmetry between upper crownsDue to the root’s long standing recurrent infection, the bone at the front of the root had resorbed and the gum margin had shrunk back.

 

As a result the patient had asymmetry between his upper crowns with one crown looking longer than the other.

Soft Tissues Grafting Before After - Upper tooth extracted So we first extracted the root but in a gentle and careful fashion to avoid any more damage to the bone and gum margin.
Soft Tissues Grafting Before After - Extraction socket after root extractionThe extraction socket can be seen here immediately after root extraction.

 

If the socket is left to heal as it is, very rapidly the gum margin will shrink even further due to the lack of bone. This will mean that the implant placed in future will be cosmetically compromised.

Soft Tissues Grafting Before After - Root outside fracture/ decay broken postThe root can now be seen outside of the mouth with fracture and decay and a broken post.
Soft Tissues Grafting Before After - Porcine derived Bio-Gide membrane outside gumWe first placed a Porcine derived Bio-Gide membrane between the outside gum and the socket to stop the gum from collapsing into the socket.
Soft Tissues Grafting Before After - Extraction socket Bovine derived Bio-Oss bone grafting granulesWe then placed Bovine derived Bio-Oss bone grafting granules within the extraction socket to build it up. This promotes the patients body to lay down more of his own bone into the socket.
Soft Tissues Grafting Before After - Bone formation perio collagen membrane over Bio-Oss GranulesWe then placed a Perio Collagen membrane over the Bio-Oss Granules to keep them there and give them time to act as a scaffolding for bone formation.
Soft Tissues Grafting Before After - Raised gum flap periosteum palatal area granulationWe raised a gum flap from the patients palate. We left the periosteum intact to allow the palatal area to heal by granulation.

 

We attached the soft tissue graft to our extraction socket with sutures.

Soft Tissues Grafting Before After - Soft tissue graft attached socket .The soft tissue graft is now fully attached to the socket and fully protecting the bone graft material within the socket. In time, the gum in this region will replace the soft tissue graft.
Soft Tissues Grafting Before After - Newly formed bone implant after six monthsThe socket will now be left for 6 months to allow the patients own bone to replace the bone graft granules. We can then use the newly formed bone to place an implant.

 

The patients own gum will now heal at a higher level allowing the future implant to have a much better cosmetic finish.

 

A few months later…

 

Soft Tissues Grafting Before After - Dental implant surgically placedWe then placed the dental implant surgically.
Soft Tissues Grafting Before After - Front tooth crown changed aestheticsWe proceeded to change the other front tooth crown as well for better aesthetics.
Soft Tissues Grafting Before After - Model patient two crown teeth placedHere you can see the two crowns on a model of patients teeth.
After Soft Tissues Grafting - Front crown implant placedThe two front crowns were placed into the patients mouth. One crown is on an implant and the other on a natural tooth.
Before After Soft Tissues Grafting - End result close upA close-up of the end result.
Soft Tissues Grafting Before After - Upper tooth ill crown fitting/ root decayBefore After Soft Tissues Grafting - End result close up

Finally, please note the final even gum position on the front two teeth.

 

So you can see that the correct extraction of the tooth prior to implant placement is very important and should be done very carefully in order to have a better cosmetic result with the implant treatment.