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[Surgery]  implant graft


This Nobel Active 3.5 X 13mm implant was placed Oct 3, 2016.

When the site was flapped it was discovered that there was good B, M and L bone but lacked any D bone. About 6mm of the root #46 was visible once the flap was opened and most of the implant distal threads were visible. Initial stability was good around 25-30 N-cm.

Unfortunately I did not have a membrane in stock and I just took the PRF course and am waiting for supplies to come in.

I decided to place a cover screw with Nobel Creos cortical bone graft and I pressed a Foundation by J. Morita collagen plug flat into a membrane type appearance and sutured over top, some of the plug was visible and not primary closure. The pt tore a few sutures loose and on his 1 week follow up I could see some access into the graft site.

I decided to apply local again and sutured completely for primary closure now.

I am worried of graft contamination and the amount of distal bone loss, no D wall at all.

What would you recommend as tx?

Open site, removed graft material, irrigate with what?, clean implant threads?, place PRF and Hiossen powder bone mix, place collagen membrane and PRF membrane and suture up?

Any guidance would be appreciated.

Thanks


by Mike Budrewicz at Wed, Oct 19, 2016 10:34 PM

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