title: Negotiating the severely resorbed extraction site: a clinical case report with histologic sample.
abstract: The treatment of an infected socket with a severe facial dehiscence/ fenestration defect presents a therapeutic dilemma to the dental team. Both implant-supported restoration and fixed partial denture are viable options to restore function and occlusion, each with its benefits and disadvantages. In the present case report, a multi-stage regenerative approach was selected to enable implant-supported single crown. The first phase of the treatment after extraction of the maxillary central incisor was the stabilization of the blood clot with a collagen plug. Six weeks later, the surgical site was re-entered and the socket was grafted with biphasic calcium sulfate (BCS). Six months later, a dental implant was placed and a core biopsy taken. However, the central portion of the facial defect demonstrated only partial regeneration resulting in exposure of six implant threads. Freeze-dried bone allograft (FDBA) and a collagen membrane were utilized to augment the ridge and cover the exposed threads. The histology of the bone core showed a complete resorption of the grafted material with the presence of new woven bone throughout the specimen. Clinically, complete defect regeneration and augmentation of the alveolar ridge were attained after 4 months. Thus, the clinician should consider the pros and cons of this regenerative approach along with other more conservative treatment alternatives when dealing with similar cases.
authors.forename: Chin-wei
authors.initials: CW
authors.lastname: Wang
authors.forename: Samuel
authors.initials: S
authors.lastname: Koo
authors.forename: David
authors.initials: D
authors.lastname: Kim
authors.forename: Eli E
authors.initials: EE
authors.lastname: Machtei
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods; D001706:Biopsy; D016025:Bone Transplantation / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D006801:Humans; D007180:Incisor / Q000601:surgery*; D008437:Maxilla; D008875:Middle Aged; D010027:Osteotomy; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000473:pathology / Q000601:surgery*; D014081:Tooth Extraction; D020390:Tooth Socket / Q000473:pathology / Q000601:surgery*
chemical_list: D015921:Dental Implants