case_images: PMC4238035_01
case_images: Pre-operative intraoral examination (a). Teeth 46 an 47 are
  lacking (b).
case_images: TODENTJ-8-194_F1.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F1.jpg
case_images: F1
case_images: The patient was missing teeth 46 and 47 (Fig. 1a, 1b); clinical and radiographic examination revealed a severe vertical defect of the corresponding alveolar ridge (Fig. 2).
case_images: Flap preparation. Mental nerve isolation (a) and alveolar
  ridge exposure (b).
case_images: TODENTJ-8-194_F3.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F3.jpg
case_images: F3
case_images: On the buccal side, the inferior mental nerve was isolated, and the flap was released with a horizontal periosteal incision to provide passive adaptation (Fig. 3a, 3b).
case_images: Flap preparation. Lingual flap isolation (a); the mylohyoid
  muscle insertion is removed and flap released (b).
case_images: TODENTJ-8-194_F4.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F4.jpg
case_images: F4
case_images: On the lingual side, the flap was elevated until reaching the mylohyoid line (Fig. 4a). The blunt instrument was therefore positioned below the connective band, and with gentle traction in the coronal direction, the muscular insertion was detached from the lingual flap (Fig. 4b).
case_images: Implant-like pin in position.
case_images: TODENTJ-8-194_F5.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F5.jpg
case_images: F5
case_images: Implant, Biotec BTK, Italy) was placed (Fig. 5). Its platform on the ideal line was located 2 mm below the cementoenamel junction (CEJ) of the adjacent teeth but 2.5 mm above the alveolar ridge because of the vertical bone defect in the first molar region (Fig. 6).
case_images: Positioned dental implant with a cower screw on it in frontal
  (a) and occlusal (b) views.
case_images: TODENTJ-8-194_F6.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F6.jpg
case_images: F6
case_images: Implant, Biotec BTK, Italy) was placed (Fig. 5). Its platform on the ideal line was located 2 mm below the cementoenamel junction (CEJ) of the adjacent teeth but 2.5 mm above the alveolar ridge because of the vertical bone defect in the first molar region (Fig. 6).
case_images: Positioning of the high density d-PTFE titaniumreinforced
  membrane to cover the grafted site. Heterologous porcine-
  derived biomaterial positioned to fill the peri-implant defect
  and to support the membrane (a); note the series of holes on the
  vestibular surface performed to induce bleeding and trigger bone
  regeneration. Definitive membrane fixing (b).
case_images: TODENTJ-8-194_F7.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F7.jpg
case_images: F7
case_images: To obtain profuse bleeding from the marrow of the bone graft recipient sites, a series of holes were drilled on the vestibular and crestal bone surfaces in zone 46, using a round bur with a diameter of 1.2 mm (Fig. 7a, 7b).
case_images: Post-surgical endoral x-ray showing the correct implant
  positioning and bone defect restoration.
case_images: TODENTJ-8-194_F8.jpg
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case_images: F8
case_images: Radiographic examination was performed to verify correct implant positioning and bone- defect restoration (Fig. 8).
case_images: Second surgery showing the membrane retrieval (a) and
  the uneventful healing of the recipient site (b).
case_images: TODENTJ-8-194_F9.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F9.jpg
case_images: F9
case_images: The screws were removed, and the membrane was retrieved (Fig. 9a, 9b, 10a).
case_images: The uneventful healing of the recipient site (a). Histological
  analysis of the biopsy collected at the regenerating site
  showing the presence of acidophilic bone tissue in close contact
  with basophilic graft material and no fibrous tissue interposition.
  Osteocytes in the lacunae indicate that the acidophilic tissue is
  newly-formed vital bone (b).
case_images: TODENTJ-8-194_F10.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F10.jpg
case_images: F10
case_images: The screws were removed, and the membrane was retrieved (Fig. 9a, 9b, 10a). After hematoxylin-eosin staining, slides were observed under an optical microscope with transmitted light to analyze bone tissue and assess bone formation at the grafted site (Fig. 10b).
case_images: Single-crown definitive restoration in frontal (a) and
  occlusal (b) views.
case_images: TODENTJ-8-194_F11.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F11.jpg
case_images: F11
case_images: A single-crown definitive restoration was delivered 1 month (Fig. 11a, 11b).
case_images: Follow-up x-ray at 1-month.
case_images: TODENTJ-8-194_F12.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F12.jpg
case_images: F12
case_images: Follow-up radiographs were taken at 1, 12, and 24 months after prosthesis delivery (Fig. 12, 13, 14).
case_images: Follow-up x-ray at 12-months.
case_images: TODENTJ-8-194_F13.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F13.jpg
case_images: F13
case_images: Follow-up radiographs were taken at 1, 12, and 24 months after prosthesis delivery (Fig. 12, 13, 14).
case_images: Follow-up x-ray at 24 months displaying the stable maintenance
  of the peri-implant bone tissue levels and no sign of bone
  resorption.
case_images: TODENTJ-8-194_F14.jpg
case_images: PMC4238035_01_TODENTJ-8-194_F14.jpg
case_images: F14
case_images: Follow-up radiographs were taken at 1, 12, and 24 months after prosthesis delivery (Fig. 12, 13, 14).