The ice cream cone technique, a predictable treatment possibility
Keywords:
dental implant, surgical flap, guided tissue regeneration, tooth socket.Abstract
Introduction: The volumetric preservation of bone and soft tissue after a tooth extraction has special relevance in the esthetic zone when it will be rehabilitated by a dental implant.
Objective: Describe the prosthodontics treatment in a socket with advanced buccal bone resorption, with a flapless technique for guided bone regeneration and with a dental implant and implant-supported single fixed prosthesis.
Case presentation: A case is presented of a male 62-year-old partially dentate patient. Radiographic examination showed the presence of advanced buccal bone resorption in relation to the maxillary left lateral incisor. It was a result of the root displacement secondary to root fracture. In a first surgical phase the lateral incisor was extracted using an atraumatic periotome technique. Particulate cortical bone allograft was compacted into the site to fill the space that was previously occupied by the root of the tooth. Temporary restoration was performed using the extracted natural tooth, which was adhesively bonded to the adjacent teeth. Four months after grafting the extraction site showed an adequate height and width of the bone. In a second surgical phase, an implant was placed. Six months after implant placement, osseointegration was clinically confirmed and a provisional crown was screwed on the implant performed. The final restoration with a zirconium dioxide abutment and a full ceramic crown was obtained and cemented.
Conclusions: Regeneration of the buccal plate was possible through the use of particulate cortical bone allograft and a resorbable collagen membrane adapted to the bone defect and placed in a position to recreate the buccal plate. This allowed the installation of an implant 4 months later, the procedure allowing esthetic and functional results using a single fixed prosthesis.Downloads
References
Elian N, Cho SC, Froum S, Smith RB, Tarnow DP. A simplified socket classification and repair technique. Pract Proced Aesthet Dent [Internet]. 2007 [acceso 07/07/2019];19(2):[aprox. 7 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/17491484
Sarnachiaro GO, Chu SJ, Sarnachiaro E, Gotta SL, Tarnow DP. Immediate Implant Placement into Extraction Sockets with Labial Plate Dehiscence Defects: A Clinical Case Series. Clin Implants Dent Related Res [Internet]. 2016 [acceso 07/07/2019];18(4): [aprox. 9 p.]. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/cid.12347
Changi K, Greenstein G. Cytocone Procedure: Conservative Repair of a Buccal Plate Dehiscence in Preparation for Implant Placement. Compendium of Continuing Education in Dentistry (Jamesburg, NJ: 1995) [Internet]. 2018 [acceso 07/07/2019]; 39(5):[aprox. 6 p.]. Disponible en: https://europepmc.org/abstract/med/29714495
Ten Heggeler J, Slot D, Van der Weijden G. Effect of socket preservation therapies following tooth extraction in non‐molar regions in humans: a systematic review. Clin Oral Implants Res [Internet]. 2011 [acceso 07/07/2019];22(8):[aprox. 10 p.]. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0501.2010.02064.x
Al-Juboori MJ. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue. Open Dent J [Internet]. 2016 [acceso 07/07/2019];10:[aprox. 7 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093866/pdf/TODENTJ-10-561.pdf
Tan-Chu JH, Tuminelli FJ, Kurtz KS, Tarnow DP. Analysis of buccolingual dimensional changes of the extraction socket using the "ice cream cone" flapless grafting technique. Int J Period Restorative Dent [Internet]. 2014 [acceso 07/07/2019];34(3):[aprox. 5 p.]. Disponible en: https://doi.org/10.11607/prd.1605
Soldatos NK, Stylianou P, Koidou VP, Angelov N, Yukna R, Romanos GE. Limitations and options using resorbable versus nonresorbable membranes for successful guided bone regeneration. Quintessence international (Berlin, Germany : 1985) [Internet]. 2017 [acceso 07/07/2019];48(2):[aprox. 17 p.]. Disponible en: http://qi.quintessenz.de/index.php?doc=abstract&abstractID=37133/
Basualdo J, Ivankovic M, Kuzmicic J, Fernández E. Atraumatic Extraction and immediate implant placement into infected site with the “ice cream cone” technique and L-PRF: A Case Report. Rev Clin Periodoncia Implantol Rehabil Oral [Internet]. 2018 [acceso 07/07/2019];11(1):[aprox. 4 p.]. Disponible en: https://scielo.conicyt.cl/scielo.php?pid=S0719-01072018000100043&script=sci_arttext&tlng=en
Published
How to Cite
Issue
Section
License
Authors retain all rights to their works, which they can reproduce and distribute as long as they cite the primary source of publication.
The Rev Cubana Estomatol is subject to the Creative Commons Attribution-Non-Commercial 4.0 International License (CC BY-NC 4.0) and follows the publication model of SciELO Publishing Schema (SciELO PS) for publication in XML format.
You are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.