Implant placement in the anterior maxilla provides many unique challenges to the clinician, including esthetics and potential alveolar bone anatomic variations. The depth of the implant osteotomy is a key consideration to avoid a fenestration defect, which could necessitate subsequent treatment. Treatment options for such defects include bone augmentation with or without implantoplasty. Bone augmentation for the correction of dehiscence or fenestration defects on restored dental implants can be difficult due to the grafted site being close to the margin of the flap, thereby favoring premature bone graft and/or barrier membrane exposure. This article describes the management of an implant fenestration defect using lasso guided bone regeneration, a contemporary technique for bone augmentation and alveolar reconstruction designed to maximize predictability and tissue quality by combining fast-absorbing bone replacement materials with long-lasting barrier membranes and stabilization with internal periosteal sutures.
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