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Management of anterior dentition failure via the HAT-TRICK technique
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Oral SurgeryFree Access
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The case represents a 65-year-old healthy male with a stage IV grade B periodontitis, generalized recessions, grade 3 mobility in the anterior sector. Deep pockets were detected. Radiographic images showed infrabony defects while the cold test showed vital teeth, therefore, a decision was made to perform a periodontal surgery and treat the observed infrabony defects in conjunction with a glass fiber splint placed on the palatal side of the anterior 8 teeth. 2 months post-operatively, a failure of the periodontal surgery was discovered, and dental implant therapy was decided. Upon flap reflection and extraction, the buccal plate of the left incisor was missing. Two implants (4.0 X10mm) were placed immediately in the lateral incisors sockets following the ""Dual-zone"" concept. A GBR using a mix of cross-linked hyaluronic acid (xHyA) + DBBM covered with a dense acellular collagen membrane generally used for soft tissue augmentation was performed. Following the “HAT-TRICK” technique principles, the membrane was fixed with bone tacks and perforated to allow provisional abutments to emerge through it. The flap was sutured passively in a way to keep the muco-gingival junction undisturbed leaving exposed areas. xHyA was added over the exposed areas for accelerated healing. Subsequently, a screw-retained acrylic provisional bridge was placed over the abutments. 3 months post-operatively, the patient received a screw retained layered zirconia bridge. The clinical challenge in this case was to restore a balanced and esthetic smile in a severely damaged anterior sector without the need for multiple surgeries.
Bachar Husseini
- Oral Surgeon & Implantologist, graduated from Saint Joseph University of Beirut (2020)
- Owner & Oral Surgeon at Dental Square Clinic, Beirut, Lebanon
- Author of 12 peer-reviewed publications in oral surgery, implantology, and orthodontics
- First Prize Laureate - Written & Spoken Communication, 67th Congress of the French Society of Oral Surgery
- Clinical focus: Immediate implantology, hard & soft tissue grafting, full-arch rehabilitation
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