DL Oral SurgeryBone reconstruction · Khoury philosophy

July 25, 2013

Implant Surgery After Reconstruction in the Anterior Maxilla

2013year
20photographs
—sections
Implant Surgery After Reconstruction in the Anterior Maxilla

This case describes a successful example of implant surgery after reconstruction in the anterior region. Four months earlier, we completed a bone graft procedure to correct a failed implant site in the same area.

📎 See the full reconstruction procedure


Re-Entry and Implant Planning

When the patient returned for follow-up, we confirmed graft stability and scheduled the implant surgery. To begin, we performed an intracrevicular incision with vertical releases placed away from the graft. This incision design preserved blood supply and soft tissue integrity.

After lifting the flap, we assessed the grafted bone. It appeared well integrated and vascularized, showing no signs of resorption. Once we removed the fixation screws, we proceeded with drilling.


Bone Quality and Implant Placement

Drilling through the graft confirmed its density and stability. The bone offered strong resistance, indicating good mineralization. We placed two implants—one in the central incisor position and the other in the lateral—achieving high primary stability in both cases.

After positioning the implants, we sutured the flap carefully to support healing.


Next Steps and Restorative Planning

Now that the implants are in place, we will wait three months to complete osseointegration. After this phase, the patient will undergo a second-stage surgery. This will include a connective tissue graft to improve esthetic outcomes.

Soon after, we will refer the patient to our prosthodontist for final restoration and occlusal adjustment.

📎 PubMed: Bone graft integration and implant success
🔗 More anterior implant cases

Initial situation
Initial situation
Defect occlusal view
Defect occlusal view
Defect
Defect
Reconstruction occlusal view
Reconstruction occlusal view
Filling in graft
Filling in graft
Everything closed after 4 months
Everything closed after 4 months
Occlusal view
Occlusal view
Incision
Incision
Appearance of graft
Appearance of graft
Screws completely covered by bone
Screws completely covered by bone
Bleeding bone
Bleeding bone
Occlusal view
Occlusal view
Implant parallelism
Implant parallelism
Bone from drill
Bone from drill
Implants placed
Implants placed
Intraoperative plate
Intraoperative plate
Occlusal view
Occlusal view
Occlusal view
Occlusal view
Scarring
Scarring

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