Combined soft and hard tissue augmentation for a localized alveolar ridge defect
This was a case report of a 30-year-old male patient who was referred to the Department of Periodontology, Kanti Devi Dental College and Hospital, Mathura, India for correction of ridge defects in the lower anterior region. Patient gave a history of extraction of the mandibular right canine due to periodontal reasons around 6 months back. On intra-oral examination, loss of ridge height and loss of facio-lingual width was noticed. Hence, a diagnosis of Seibert's Class III alveolar ridge defect was made []. Grade I recession was noticed on the mandibular right lateral incisor and canine. A treatment plan involving augmentation of the alveolar ridge defect with bone grafts and soft-tissue grafts was formulated, informed to the patient and consent was obtained.\nAfter achieving adequate local anesthesia, vertical releasing incisions were placed on the distal line angle of lateral incisor and mesial line angle of first premolar. A full thickness flap was elevated until the muco-gingival junction and partial thickness flap was reflected beyond the muco-gingival junction []. Granulation tissue/connective tissue present at the base of the defect was removed. A template was used to determine the size of the soft-tissue graft needed to augment the defect. MucoMatrixX, an animal derived, collagen based soft-tissue graft was sutured to the labial flap []. Bone graft was placed into the defect. Labial flap was coronally advanced and interrupted sutures were placed to unite the labial and lingual flaps. Periodontal pack was placed and patient was recalled after 10 days for suture removal. Post-operative instructions were given and analgesics were prescribed for pain control. After 10 days, sutures were removed and remarkable improvement in ridge thickness and height was noticed. One month later, after evaluation of the ridge contour and dimensions, patient was referred to Department of Prosthodontics for placement of the prosthesis. All possible prosthetic options were discussed with the patient. Due to financial constraints, patient could not afford for implant supported prosthesis, instead patient choose for a fixed prosthesis. A porcelain fused to metal crown with mandibular left lateral incisor and mandibular left first premolar as abutment was delivered to the patient []. Patient is being followed without any major complaints.