In this operation Prof. Hürzeler starts with raising a full flap using a sulcular incision and a micro scalpel blade. After checking the surgical template, a subepithelial connective tissue graft is taken from the palatal region. Care has to be taken not to hit the palatal artery and to leave a palatal epithelial thickness of approximately one millimetre to avoid healing problems.
The palatal wound is closed by a running suture and a splint is placed to support the initial healing period. The periosteum of the buccal flap is then split to mobilise the flap further. The residual bone of the planned implant site is perforated to increase blood supply for the artificial bone and the implant position is marked with a surgical template.
The implant is placed and a few coronal threads are exposed. In order to create a stable situation a membrane is fixed firstly with pins followed by augmenting the exposed threads with bone of bovine origin (BioOss) and covering both with the subepithelial graft. The closing of the wound is conducted with mattress and interrupted sutures under the avoidance of any tension.