I extracted the maxillary central incisor. Now I was missing three teeth in the anterior section. All that was remaining was the maxillary canines and the maxillary left lateral incisor. I was able to place one implant in the area of the left maxillary incisor (That site was grafted right after the extraction and allowed to heal for 6 weeks), but the ridge was much too thin to support an implant in the right anterior section.

The radiograph shows the initial implant placement plus three tacks that are holding a large membrane in place. It is very difficult to see, but if you look very carefully at the top photo at the left, I have put about 20 bur holes into the labial surface of the edentulous ridge in preparation of grafting the site.

I elected to use freeze dried bone mixed with Bio-Oss as my grafting medium. I overbuilt the ridge and place a large barrier membrane (IMTEC) stabilizing it with four tacks.

Four months later, I went in and removed the membrane. You can see the membrane and two of the tacks on the left. There was no soft tissue perforation and the membrane stayed intact and totally covered.

With the membrane removed, the new bone is evident completely filling out the concavity that had originally existed in the bone and giving me enough bone support for implant placement.