Dr. Marc Hinze, Gräfelfing/Germany, demonstrates the implantation of two implants in an augmented area in the mandible to replace teeth 36 and 37. Horizontal bone augmentation was conducted four months ago in order to increase bone volume at the implant site. For the successful implantation, sufficient bone volume is a prerequisite. For this reason, horizontal bone augmentation was conducted four months ago in order to increase bone volume at the implant site.
Using the GBR technique, two autologous bone rings were applied and fixated with screws; in addition bone substitute material was placed. The augmented area was covered by two membranes - a bone-lamina membrane and an Evolution membrane (resorbable collagen membrane) - to create and maintain space for bone in-growth. In the present surgery - four months later – in the molar region bone is exposed after crestal incision and the preparation and elevation of a full thickness flap. It is visible that the augmentation was successful: horizontal bone width of 6 mm was obtained and only minimal bone resorption has occurred.
Next, pilot drillings are conducted to determine the prothetic axis. The implant beds are gradually extended, always paying attention to implant position and direction, as well as the nerve in the apical region. Since the vertical bone volume is limited, only short implants of 6 mm length can be inserted. Also, in the buccal region, the bone volume is still reduced, so that the implants coronally are not fully covered, which is a disadvantage for the success of the implantation. At implant uncoverage, Dr. Hinze plans to thicken and stabilize the soft tissue with a free gingival graft.