Guided Bone Regeneration With Tsv Gel and Ptfe Membrane

Abstract

Introduction Localized Stage IV periodontitis in the anterior region presents management challenges due to exacerbated bone loss, which can affect aesthetics by compromising the vertical dimension [1].This case highlights the use of TSV Gel, a collagen-based heterologous (xenogenic) grafting material, in combination with a PTFE membrane for bone augmentation. TSV Gel has great properties for bone regeneration, including good stability and strong support for the graft [2]. Case Presentation The patient, born on March 1, 1985, presented with a mobile bridge spanning teeth 12–21 and a Grade 3 mobile tooth 22. Secondary occlusal trauma was evident. Tooth 12 and 21 had poor endodontic treatment, with probing depths reaching the apex and radiographic evidence of surrounding issues. Localized bone loss extended to the lower third of the teeth. The patient was diagnosed with Stage IV localized periodontitis, Grade B. Teeth 12, 21, and 22 were extracted, followed by 3 months of healing. Bone augmentation was performed on 13/07/2023 using: Two syringes of OsteoBiol TSV Gel and One Creos Syntoprotect PTFE membrane. A check-up conducted a couple of months prior to implant placement, including X-ray examinations, revealed a vertical bone gain of 10.8 mm. On 14/02/2024, Three Nobel Biocare implants (4.3 × 10 mm for region 12, 4.3 × 11.5 mm for regions 21 and 22) were placed. The final prosthetic abutment (implant-supported fixed bridge) was placed on 25/08/2024 A follow-up on December 27 revealed that everything was healthy, with no complications observed Discussion Localized Stage IV periodontitis with severe bone loss in the anterior region is rare and can hinder implant placement. Protecting the nasal region’s integrity highlights the necessity of bone augmentation. Guided tissue regeneration with TSV Gel and a PTFE membrane achieved 10.8 mm of bone gain, sufficient for implant placement. However, due to the severity of bone loss, longer crowns were required to restore proper occlusion and aesthetics. The patient's aesthetics were achieved, but due to the complexity of the bone loss, it was not perfect, but sufficient to successfully treat the case. Conclusions Guided bone regeneration with TSV Gel and a PTFE membrane achieved 10.8 mm of vertical bone gain, providing space for implants. This method works well for moderate bone loss but not severe cases.