Khoury Plate Technique & Connective Tissue Graft

Case Study 5

CASE DESCRIPTION:

The patient presented with a failed mandibular central incisor, which, following root removal, resulted in both vertical and horizontal bone deficiencies. This type of defect poses a significant challenge, particularly in achieving sufficient bone volume for ideal implant positioning and long-term stability. A carefully staged regenerative approach was therefore essential to rebuild the site and create a predictable foundation for implant therapy.

To address the defect, Dr. Nik implemented the advanced Khoury Plate technique, showcasing a high level of surgical skill and precision. A cortical bone block was harvested from the mandibular ramus and meticulously processed into a thin, approximately 1mm cortical plate, alongside autogenous bone particles. This technique allows for optimal use of the patient’s own bone, enhancing biological integration and regenerative potential.

The cortical plate was then precisely adapted and securely fixed to the residual ridge using fixation screws, effectively recreating the missing bony contour and maintaining space for regeneration. The autogenous bone particles were carefully packed within the defect, promoting vascularisation and new bone formation. This structured and biologically driven approach ensured stability throughout the healing phase.

After a smooth and uneventful healing period of just four months, sufficient bone regeneration had been achieved to proceed with implant placement. Dr. Nik then placed a Conelog Progressive implant from BioHorizons in an ideal, prosthetically guided position. To further optimise the aesthetic and functional outcome, a connective tissue graft was harvested from the tuberosity to enhance soft tissue thickness, improve contour, and support long-term peri-implant stability.