# Horizontal defect in upper molar – Bone block and implant

URL: https://dloralsurgery.com/blog/horizontal-defect-in-upper-molar/

September 17, 2014

**2014** year

**12** photographs

**3** sections

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![Horizontal defect in upper molar – Bone block and implant](https://dloralsurgery.com/fotos/2014/01/031.jpg)

[![Refuerzo por vestibular](https://dloralsurgery.com/fotos/2014/01/031-300x200.jpg) Vestibular reinforcement](https://dloralsurgery.com/fotos/2014/01/031.jpg)

We present the case of a 55-year-old patient, medically healthy, referred for assessment and treatment of a **horizontal defect in the upper molar** area. The main concern involved the upper right premolar region, where the patient needed a dental implant.

Clinical and radiographic examination revealed a **horizontal bone defect**, caused by a traumatic extraction that had led to loss of the buccal plate. This defect compromised the ridge volume and required bone augmentation before or during implant placement.

## Reconstructing the horizontal defect in the upper molar region

To restore the defect, we opted for a **crestal approach**. This allowed us to place the implant in the ideal prosthetic position while simultaneously grafting the defect.

We harvested a **cortical block from the mandibular external oblique ridge**, dividing it into two thin plates for better vascularization. The internal space of the graft was filled with autogenous particulate bone, enhancing integration and volume stability.

## Second surgery and additional implant placement

One month later, the patient returned due to a vertical fracture in the adjacent tooth (#15). We placed a second implant in that position. Unfortunately, no images were taken during that procedure.

After 3 months, we performed the second-stage surgery. The regenerated site showed excellent bone volume and density. The horizontal defect appeared fully resolved, with stable integration of the implant.

## Final prosthesis and follow-up

The prosthodontist at the referring clinic completed the case with a functional and esthetic prosthesis.

📎 To see more cases like this **horizontal defect in upper molar**, visit our clinical archive for detailed surgical documentation and outcomes.

Below, you’ll find photos of the original surgery, second-stage exposure, and final restoration.

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/001.jpg)

Previous situation

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/021.jpg)

Placement of the implant

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/031.jpg)

Vestibular reinforcement

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/041.jpg)

Particulate filling in

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/081.jpg)

Implant in position 15

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/091.jpg)

X-ray of both implants

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/0101.jpg)

Image of bone in the second stage

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/0111.jpg)

Image of bone

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/0131.jpg)

Photo with prosthesis

![horizontal defect in upper molar](https://dloralsurgery.com/fotos/2014/01/0141.jpg)

Final x-ray

[← Previous case **Socket preservation in the aesthetic zone – Clinical case**](https://dloralsurgery.com/blog/socket-preservation-absence-of-buccal-bone-plate-in-aesthetic-front/) [Next case →**Frenectomy and connective tissue graft – Recession…**](https://dloralsurgery.com/blog/recession-frenectomy-and-tunnelled-connective-graft/)

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