[Diagnostic / Planning]  Ailing 1.2

Dear Colleagues,

I am planning an open flap, Ibrush, ErCrYag, decontamination, with a PRF, sticky bone graft.  I haven't used the ibrush yet, but have watched Mark's vid and am not concerned about that.  My question is: what type of flap would you use to gain access.  ie. extension and design seeing as it is in the esthetic zone although lip line is favourable. Any suggestions in general regarding this case would be appreciated.



by Lonny Legault at Thu, Mar 30, 2017 2:12 PM

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Admin BITES Replied at Fri, Mar 31, 2017 10:58 AM

Hi Lonny,

Surgical Smart will contact you regarding the fixture removal kit. 

Likes : 1

Lonny Legault Replied at Thu, Mar 30, 2017 3:08 PM

Hi, Mark!  Great to hear from you too.   Yes, indeed it is a Tapered Internal Biohorizon 3.5mm.   

I will do just as you recommended.  

Thank you.


PS- prior to pressing reply i looked on and could not find the fixture removal kit?   

Likes : 1

Mark Kwon Replied at Thu, Mar 30, 2017 2:57 PM

Dear Lonny,

Good to hear from you.

since it is #12 , an esthetic zone, i would recommend ' distal-remote incision' .

meaning, mesial to 12, use envelop incision, and at distal line angle of #13 make an oblique vertical incision to gain access to the necessary areas of #12.

I would remove crown , then place cover screw, i-brush the area thoroughly with alot of water.  Make sure you look for any sign of implant fractures!  Im not sure what implant system that is , is it Biohorizon?. 

I have been getting quite few number of implant vertical fractures lately , especially on 3.5 diameter fixtures.  

In case, you require to remove the fixture and replant the area at the same time,  I highly recommend checking out 'universal fixture removal kit' from


- mark

Likes : 1

Lonny Legault Replied at Thu, Mar 30, 2017 2:51 PM

not really, screw retained, occlusion is good,  ,   maybe  implant placement was a bit too buccal??

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Keyhan Alavian Replied at Thu, Mar 30, 2017 2:35 PM


Any theories on how the boneloss happened in the first place?