Everything is not always as it may appear. This patient had fractured his upper left central incisor and the tooth needed to be extracted and grafted for a future implant. Intra orally everything around the edentulous space for #10 looked fine until we looked at the CBCT. There was a large infectious cyst space that had destroyed a lot of bone which can be seen in the huge defect surgically once we flapped the area. Once the area was cleaned we grafted both sites #9 and #10 and used a double layer membrane technique. Often times on large defects I like to use one layer of resorbable collagen membrane vertically and one layer horizontally and I’ll do this by using a larger 30×40 membrane.

I was excited to go back into the area after getting a CBCT after 8 months of healing and you can see the awesome bone regeneration we were able to achieve in terms of width and density from the CBCT cross sections.

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