Guided Bone Regeneration Prior to Implant Therapy in the Esthetic Zone: A Case Report

Benso Sulijaya1, 2, *
, Felix Hartono Koerniadi1
1 Department of Periodontology, Faculty of Dentistry, Universitas Indonesia. Jakarta, Indonesia
2 Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion; Division of Periodontology, Department of Oral Biological Science. Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

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© 2022 Sulijaya and Koerniadi

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Periodontology, Tower B, 2nd Floor. Faculty of Dentistry, Universitas Indonesia. Salemba Raya no. 4. Jakarta Pusat 10430, Indonesia; Tel/Fax; (+6221) 3911502; E-mails:,



Implant placement on the anterior maxilla requires a comprehensive concern of adequate alveolar bone and gingival biotype. Insufficient support for hard and soft tissues becomes one of the main causes of implant complications. To avoid this problem, pre-surgical treatment with Guided Bone Regeneration (GBR) is suggested with respect to the alveolar ridge defect.


In this study, we reported the predictability of a sandwich technique of GBR prior to implant placement.

Case Presentation:

Case: Thirty-four-year-old male was referred with a chief complaint of missing teeth on area #21 accompanied by labial bone dehiscence due to trauma. Bone thickness measurement displayed was approximately 3/4/5 mm (coronal/middle third/apical third of the alveolar ridge). This case was diagnosed as soft and hard tissue deformity on area #21 prior to implant. Case management: GBR and implant placement were performed in two stages of surgery. GBR was executed by using a combination of Biphasic Calcium Phosphate (BCP) (consisting of 40% Beta-Tri Calcium Phosphate (β-TCP) and 60% Hydroxyapatite (HA)) and Demineralized Freeze-Dried Bone Allografts (DFDBA) bone graft materials. Alveolar ridge re-measurement five months after GBR showed significant bone augmentation, 6/6/6 mm (coronal/middle third/apical third of the alveolar ridge). Furthermore, a 3.5 mm (diameter) x 10 mm (length) bone-level implant was inserted accordingly. The two-year follow-up exhibited gingival stability and no sign of either recession or bone resorption.


Herein, we demonstrated the effectiveness of BCP and DFDBA bone substitutes to obtain proper conditions for the long-termed stability and predictability of implant.

Keywords: Guided bone regeneration, Implant, Alveolar ridge defect, Case report, BCP, DFDBA.