1999 年 12 巻 4 号 p. 570-576
Amons ordinary clinical cases, there are various compromised cases of ideal implant placement without primary stability. The autogenous bone graft or guided bone regeneration (GBR) procedure are used to solve these cases, however, there are some technical problems involved in how to obtain the primary stability with little predictability to obtain the perfect regenerated tissue in the case of severe bone defect. Furthermore, it is necessary to build a sufficient amount of bone for implant placement, when the implant is placed at the ideal position for esthetic reasons. Three cases of implant placement utilizing titanium frame to fix the implant at ideal position and regeneration of sufficient bone height for ideal implant placement are presented. In these cases, the ideal implant position was determined using implant model at the site of bone defect, following elevation of mucoperiosteal flap. The titanium frame was shaped to fix the implant at the ideal position, then this titanium frame with implant was fixed by screws buccally and lingually. In this state, the implant was not in contact with the bone surface because of a large gap between the bone defect basement and the ideal implant head. GORE-TEXTM Augmentation Material membrane was placed over this frame and implant. The mucoperiosteal flap was closed with tension free. About 4～6 months postoperatively,sufficient amount of bone for implant stability and demanding gingival form for esthetic implant margin were obtained, when the membrane and titanium frame were removed. This report presents a technique of three-dimensional ideal implant placement at the site in which primary stability could not be obtained.
