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industry report I (Fig.4).Myexperiencewithbonecavitationssuggested asurgicalapproachthatwouldentailperforminganos- teotomyandafterwardscleaning,disinfectingandfill- ingthecavitationbeforeplacingtheimplant.Bonecav- itations are not visible at crest level (Fig. 5) because the bonydefectislocatedinsidethebonemarrow. Once the diameter of the planned implant size (5mm)hadbeenachieved,thewallsandflooroftheos- teotomy were controlled with a depth gauge. All walls except the lingual plate were missing and no floor lim- itedthe8mmlengthoftheosteotomy.Thedepthgauge established a distal hole of 10 mm. The mesial and buccal defects extended for only a few millimetres (Figs.6&7). Thefibroustissuewasremovedfromthecavitywith aLucascurette(Fig.8).Multipleapplicationsofadiode laser combined with local antibiotics were performed beforeproceedingtofillthecavity. The graft material should be 100 per cent synthetic inordertoavoidcrossinfection,asmaybethecasewith xenografts. The beta-tricalcium phosphate (␤-TCP; SynthoGraft,Bicon)wasmixedwiththepatient’sblood andinjectedintothecavity(Figs.9&10).Oncethecav- ityhadalmostbeenfilled,twoShortImplants(Ø5mm, length6mm)wereplacedintothegraft(Fig.11).Finally, the implants were completely buried under the crestal bone(Fig.12),inaccordancewiththecharacteristicsof the implant design (plateau press fitted root form im- plant). Short implants were necessary in this case because of the reduced vertical jaw dimension and the proxim- ity to the mental nerve and the inferior alveolar nerve (Fig.13). _Conclusion It is paramount for a good clinician to be able to recognise bone cavitation. Performing a correct os- teotomydependsontheintegrityofthefourwallsand thefloor.Ifoneormoreofthestructuresmentionedare missing during inspection with the depth gauge, the quality and consistency of the bone marrow should be tested. In some cases, a screw-retained implant may be re- tainedinthecrestalboneonlywhilemostoftheimplant bodyisunstablebecauseofthepresenceofahole.Ow- ingtothemultifactorialcauseslistedinthisarticle,the cancellous bone in that specific area has become necrotictissue,creatingthecavitation._ Editorial note: A list of references is available from the pub- lisher. Figs. 11 & 12_Two 5 x 6 mm Short Implants (Bicon) are directly placed into the graft and buried under the crestal bone. Fig. 13_Evidence of the grafted bone cavitation and implant placement. Mandatory is the use of Short Implants in order to avoid proximity to the mental nerve and the alveolar nerve. I 23implants1_2014 Prof.Dr Mauro Marincola Via dei Gracchi 285 00192 Rome,Italy _contact implants Fig. 11 Fig. 12 Fig. 13