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IM0410

I user report _ alveolar ridge reconstruction Fig. 1_Presurgical aspect revealing massive Periodontitis and bone resorption in region 32, 42, 44. Fig. 2_The CB-Scan exposing region 32—with partial loss of the buccal and lingual wall region 32–44. _Introduction Ahighclinicalevidenceofgraftingproceduresfrom extraoralautologeousdonorsiteslikei.e.fromtheiliac crestindifficultbonelosssitesisstillthepracticeinoral or oral-maxillofacial surgery. However, the invasive surgery combined with a prevalence of patients mor- bidityandsufferisanissuetodiscussthepersistingle- gitimation of this procedure. Since the appearance of reliable bone substitute materials with or without any autologeousboneadded,thepositiveresultsconcern- inglongtermstabilityofregeneratedboneevenindif- ficultcaseshavebecomeverypredictable. This article will point out in a case report the relia- bility of alternative and less invasive techniques for 3-Dbonereconstructioninthemandibleandquestion thenecessarityofiliachipgraftsforintraoralboneaug- mentation. _Materials and methods Afemalepatientaged48yearsoldwithasevereand advancedperiodontitisinthemaxillaandthemandible cameintoourclinicwiththedesireofacomplextreat- ment plan with an implant retained denture in both jaws.Thiscasereportwillpinpointthetreatmentofthe mandible. A CBVT was revealing massive bone loss in height and width in the mandible arch from canine to canine and apical cyst at tooth 23, 26 and 28 (Figs.1 &2). According to our protocol we started with an ini- tial scaling and HELBO®-Laser decontamination prior to the surgery to decrease the number of pathologic germs and post op infections. Tooth 18 and 19 in the left mandible were intended to maintainuntilthefinalizationofthe prosthetics to give some comfort during temporization with an im- mediate denture that was placed postop.Preoperativethepatientre- ceived1,200mgofClindamycin.The patientdesiredthesurgeryoftooth removal and ridge augmentation persuedundergeneralsedation. After nasal intubation and local anesthesia the bridge in the lower was removed and the remaining teeth despite from 18 and 19 as mentionedbefore(Figs.3&4).After fullflappreparationwithcrestalin- cision,releasingincisionsandexpo- sure of the mental nerve exit, the volume of the severe bone loss was revealed as well as the minor soft 3-D alveolar ridge reconstruction in a case with severe bone loss Author_Prof Dr Marcel Arthur Wainwright, Germany 28 I implants4_2010 Fig. 1 Fig. 2