Aesthetic Correction of Bony Defect with Multidisciplinary Approach: A Case Study

2014 
The correction of severe malocclusion with fixed prostheses in vital tooth is crucial and may end up with complication such as loss of vitality, multiple root canal treatment and extraction that lead to major procedures. In this case report the loss of hard and soft tissue of alveolar ridge resulted from traumatic tooth extraction in conjunction of periodontal tissue destruction due to longstanding inflammation. Alveolar bone defect on the anterior region commonly affects the aesthetic. The morphology of class III bony defect on aesthetic area can be unfavorable for construction of dental prosthesis. Surgical attempt has been made to improve hard and soft tissue prior to prosthesis placement. The expertise's from multidisciplinary required in the procedures to achieve the primary aesthetic demand. Prepared provisional bridge with ovoid pontic shape on the surgical area will initiate soft tissue filling into interdental embrasure and enhance the aesthetic. The complication arises when insufficient soft tissue toward healing takes place. The replacement of exposed and infected membrane and photodynamic disinfection (Foto San) was imposed to minimize the chance of reinfection. Therefore, aim of this paper is to present the application of the invented Piezosurgery system of three dimensional ultrasonic vibrations and bone expansion gadget in the ridge augmentation procedure. The application of bone regenerative material (Puros-allograft) and bioresorbable collagen membrane (Resolut Adapt LT) ensure ridge modification. All these procedures were carried out as the consequences if inappropriate correction of severe malocclusion with extensive fixed prosthesis on vital anterior teeth.
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