Numerous studies have shown that placement of implants in the maxillary region with resultant successful osseointegration can be achieved by the use of sinus lift procedures using piezosurgical technique. In this case report a middle aged patient had come to the outpatient department of A. J. Institute of Dental Sciences with a chief complaint of missing right posterior molar. Since the radiographic ball marker showed only 4 mm bone below the sinus in #16 region, direct sinus lift procedure was done for placement of a dental implant. Piezosurgery was performed, as it reduces the risk of damaging vital soft tissues such as nerves, dura matter and blood vessels. To stabilize the implant in the maxillary sinus region and also to stimulate bone regeneration, gamma irradiated cancellous allograft was used. Periapical radiographs were taken 10 months after implant placement which showed good bone growth over the implant collar. Bone formation in the maxillary antrum was seen clearly in the panoramic radiograph. Using piezosurgical unit, sinus lift procedure with sinus grafting proved to be less traumatic and more successful.
Miller's class III gingival recession is a common entity observed in individuals, posing a difficult situation for the clinicians to treat. Large fenestration defects with cervical abrasion compromise the esthetics resulting in poor prognosis. Obtaining predictable and esthetic root coverage has become an integral part of periodontal therapy. The present case report describes a situation where class III gingival recession with cervical abrasion was seen in the lower central incisors. The patient was successfully treated with a combination of restorations (Filtek Z350® composite resin) to fill the defect, followed by fenestration procedure to increase the vestibular depth and subsequently with grafting procedure (soft tissue autograft with bovine-derived xenograft collagen [Bio-oss]). Though the results were not tangible esthetically, it was functionally successful as evidenced during the follow-up period.
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