One-Stage Approach to Rehabilitate a Hopeless Tooth in the Maxilla by Means of Immediate Dentoalveolar Restoration: Surgical and Prosthetic Considerations

Figure 3

(A) The maxillary tuberosity was the region utilized to obtain the autogenous bone block graft. (B) After local infiltrative anesthesia, a vertical and crestal incision was performed following a full-thickness flap to access the right maxillary tuberosity. (C) A straight chisel (Quinelato, Rio Claro, SP, Brazil) was used to harvest the block bone. (D) The bone graft was customized according to the form of the bone defect, (E) and it was then inserted gently into the alveolar defect above the implant threads using the flapless technique. (F) Occlusal view of the fresh extraction socket with the dental implant positioned immediately after the buccal wall reconstruction with the tuberosity bone graft, allowing a reminiscent gap between the block bone and the implant. (G) The gap was filled with particulate bone harvested from the tuberosity and ground with a bone mill (Neodent, Curitiba, PR, Brazil) to guarantee the bone block maintenance and support. (H) Final occlusal view of the particulate bone completely inserted into the gap between the block bone and the implant.