Dental Tribune United Kingdom Edition

May 23-29, 201114 Implant Tribune United Kingdom Edition page 13DTß www.velopex.com Call: 020 8965 2913 Email: enquiries@velopex.com www.velopex.com Call: 020 8965 2913 Email: enquiries@velopex.com Proud of our 50 Years in Quality Imaging, let Velopex Lead You into the Digital Future... DTo3da27.04.11rpc the gums and drilled precisely 9mm deep. When withdrawing the drill the bone meal was al- ready able to be retained. Addi- tionally further spongiose bone was extracted with a mini-ex- cavator. The transplant bone was able to be adsorbed into the im- plant body in an ideal manner. Finally a thing collagen mem- brane was applied for complete coverage. The soft tissue de- fects were closed with absorba- ble materials. The stab incision in the retromolar was glued with cyanoacrylate. In regions 031/041 the wound closure was carried out using absorbable suture material and horizontal mattress stitches. Finally, as a provisional restoration, a Maryland tem- porary prosthesis was affixed, which additionally ensured a good soft tissue stabilisation. A digital volume tomography (DVT) was produced in order to evaluate the removal defect and document the augmenta- tive result. Summary Autologous bone grafting rep- resents the gold standard in augmentation surgery. Particu- larly with implant operations it is often only shown intraopera- tively that a small quantity of autologous bone is needed for augmentation. In this situation quick reaction is often indi- cated. The retromolar space is frequented most often for this purpose. As the patient should have the least possible discom- fort due to the bone extraction, minimally invasive procedures are the means of choice. The technique presented above is a new method which is impressive due to its minimally invasive and simple character- istics. The shown procedure is especially ideal for augmenta- tion planning with volumes up to 0.5mg. Of course larger bone volumes can also be ex- tracted using this minimally invasive method. Soft tissues can be closed discreetly and so that they are hardly noticeable to the patient using adhesive techniques. Minimally invasive procedures in implantology can be perfectly planned and executed by including modern 3-D-diagnostics (DVT). DT Figs. 1 & 2_Initial situation in region 031,041. State 3 months after the removal of the teeth 31, 41. In region 041 the vestibular lamella has completely collapsed. Fig. 3_Noticeably visible three wall bone defect in region 031 vestibular. Fig. 4_After drilling the implant shafts, region 031 showed to be significantly atrophied. Fig. 5_The implant shafts are dilated using condensers and the periimplantational bone is condensed. Fig. 6_Implant insertion in the regions 031, 041. In region 031 it is visible that a vestibular augmentation must take place. Fig. 7_the implant body in region 031 must be vestibularly covered with autologous bone over approx. 2/3 of its surface. Fig. 8_Retromolar stab incision with an 11 scalpel. Fig. 9_A conventional implant drill is used to drill directly in the area of the linea obliqua through the stab incision. A “two spade drill” is excellently suited to bone extraction. Fig. 10_Bone excavation via simple shaft drilling with the conventional “two spade drill”. Fig. 11_additional bone excavation by hollowing out the shaft drill hole in the linea obliqua with the excavator. Fig. 12_Implants and autologous bone augmentation in situ. In order to achieve this result it was only necessary to drill into the retromolar! Fig. 13_Covering the implants and augmentations with a simple collagen membrane. Figs. 14 & 15_The stab incision of the retromolar extraction region is glued with cyanoacr- ylate. Hereby the patient only incurs a microscopic extraction defect. Figs. 16 & 17_The soft tissue in the implant region is closed with absorbable suture mate- rial. The neighbouring teeth 43,42,32,33 are lingually cauterised. Figs. 18 & 19_Insertion of a Maryland provisional prosthesis, directly after the augmenta- tive-implantological intervention. Fig. 20, 21, 22_ DVT of excavation defect. About the author Dr Steffen Hohl DIC Dental Implant Competence Estetalstr. 1 21614 Buxtehude, Germa- ny www.dr-hohl.de Dr Anne Sophie Brandt Petersen Tandlaegerne i Kogade Kogade 4 6270 Tonder, Denmark www.dentist.dk Fig 13 Fig 14 Fig 15 Fig 16 Fig 18 Fig 17 Fig 19 Fig 20 Fig 21 Fig 22