Uncovering of Implants and Soft Tissue Management in the Toothless Maxilla - Dental Online College
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Uncovering of Implants and Soft Tissue Management in the Toothless Maxilla

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Duration:

06:07

Surgeon:

Prof. Dr. Hürzeler

Professor Markus Hürzeler (Munich) demonstrates the split flap method that is widely used in mucogingival surgery. The aim is to extend the keratinized gingiva in the peri-implant area by apically repositioning the vestibular mucosa.


Following an incision along the alveolar ridge and relaxing incisions at the endings, a mucosal flap is created, which is mobilized towards the vestibule. The six implants that had been inserted six months ago are uncovered using a corresponding punch to remove the covering connective tissue. One nonintegrated implant and the augmentation membrane that had been placed for augmentation purposes during the implantation have to be removed. In the posterior area a graft bed is prepared for the reception of a free gingival graft. It is important to carefully remove underlying connective tissue from the periosteum. The thinned mucosal flap is then secured and immobilized in an apical position using absorbable suture material. A corresponding free gingival graft is harvested from the palate and placed in its recipient bed. An even thickness of the graft of about 1-1,5mm is desired for an undisturbed healing process.


Finally, the mucosal flap is firmly secured slightly apically with a Gore-Tex material. Uncovered areas will heal with the development of granulation tissue. In the meantime, the existing prosthesis has been reworked and adjusted to the new situation with the five uncovered implants and is inserted at the end of the surgery.

Content of the expert video

To begin with, an incision is performed along the ridge with vestibular relief followed by preparation of a mucosa flap.
To begin with, an incision is performed along the ridge with vestibular relief followed by preparation of a mucosa flap.
A free gingival (mucosa) graft of even thickness is taken.
A free gingival (mucosa) graft of even thickness is taken.
Using sling sutures, the free gingival (mucosa) graft is secured in the graft bed with pressure applied across a wide area.
Using sling sutures, the free gingival (mucosa) graft is secured in the graft bed with pressure applied across a wide area.
The anterior part of the split flap is also secured in a slightly apical position using a sling suture that is anchored in the non-mobile tissue area.
The anterior part of the split flap is also secured in a slightly apical position using a sling suture that is anchored in the non-mobile tissue area.
During the surgical procedure itself, temporary cylinder caps screwed onto the implants are inserted into the reworked prosthesis through polymerization.
During the surgical procedure itself, temporary cylinder caps screwed onto the implants are inserted into the reworked prosthesis through polymerization.

The expert

Prof. Dr. Markus Hürzeler

Private practice Hürzeler/Zuhr in Munich

  • Practising dentist in the joint practice Hürzeler/Zuhr in Munich
  • 2003 Conferment of degree; adjunct professor by the Albert-Ludwigs University in Freiburg
  • Specialist for periodontology (medical specialist equivalent) according to the Swiss (SSP) and German Association of Periodontology (DGP)
  • Specialist for prosthetics (medical specialist equivalent) according to the German Association for Dental Prosthetics and Materials Science (DGZPW)
  • Professorship at the Albert-Ludwigs University in Freiburg and at the University of Texas in Houston / Texas / USA
  • more »
  • botiss dental Gmbh
  • Henry Schein
  • DZR
  • CAMLOG
  • CLINICAL HOUSE EUROPE
  • Komet/Gebr. Brasseler GmbH &Co KG
  • DSI DentaScience Institute®
  • Kuraray
  • BEGO Implant Systems GmbH & Co. KG
  • Zimmer Dental
  • IDI-PARO
  • IPI München
  • Sirona
  • Align Technology Inc.
  • Mectron
  • Health AG
  • Dentsply Sirona Implants
  • W&H Deutschland GmbH

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The Dental Online College is an online learning platform for dental surgeons and students. This service focuses on providing superior-quality professional training videos in the area of dental medicine that can be called up from an Internet platform. As a professional online training platform, the Dental Online College provides dental surgeons and students with instruction in surgical procedure, demonstrating challenging surgical techniques using easy to understand videos, and including interviews that provide further detail, video presentations, and documentation on performing the procedures in question.

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