In this surgery Prof. Dr. Marc Hürzeler and Dr. Bolz, both Munich/Germany, are placing implants in the posterior area after a previous augmentation with a bone block. They start with raising a full flap using a sulcular and crestal incision. With a papilla elevator, a mucoperiosteal flap is lifted in the buccal and lingual areas in order to be able to estimate the bone thickness in the bucco-lingual direction.
Based on the radiological diagnostics that have been carried out, and given that sufficient bone mass is provided in the vertical direction, the surgeon decides not to expose the exit point of the nervus alveolaris inferior from the mental foramen. Following preparation of initial surface graining, pre-drilling, as well as the use of pilot and twist drills, the implant can be inserted using a machine and later on a surgical ratchet.
Primary wound closure is performed using horizontal double-sling suturing. In order to ensure permanent integration into the bone tissue, the implant is then allowed to heal over a period of approximately three months.