Bone reconstruction in the anterior maxillary section

Today we present a case of bone reconstruction in the anterior maxillary section. The patient is a 53-year-old woman with no relevant medical history who came to us wearing an 8-unit tooth-supported bridge in the upper anterior area, in place for the last 12 years.

Her previous dentist used this prosthodontic solution to restore multiple anterior diastemas following the loss of several teeth. The bridge spanned six incisors and used teeth 13, 22, and 23 as abutments. However, the periodontist and prosthodontist considered tooth 22 (left lateral incisor) non-conservable.

Planning and reconstruction technique in the anterior maxillary section

We decided to treat this patient with dental implants. However, before implant placement, a bone reconstruction of the premaxillary region was necessary due to significant horizontal atrophy from long-term edentulism.

The patient expressed a clear preference: she did not want any visible diastemas. Therefore, we planned to place four implants to support a new 6-incisor prosthesis, replicating the esthetic profile of her previous restoration.

Despite being non-conservable, we retained tooth 22 temporarily to help preserve soft tissue architecture during the revascularization of the grafts and implant placement. This tooth would be extracted and managed immediately during surgery.

We performed the bone reconstruction in the anterior maxillary section using autogenous grafts following the Khoury technique. The graft matured well over the following four months.

Implant placement and follow-up

📎 You can see the next phase of this case, including implant placement and final healing, here:
👉 Implant placement after reconstruction – anterior sector

We hope this case provides valuable insight into managing complex anterior maxillary defects using staged protocols.

Other clinical cases here!