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ePaper created 2014-11-07, 14:16:52 | version 1.30.01
I research 14 I implants3_2014 If the operator can achieve a primary and de-en- ergised wound closure, fissure dehiscence is a rare exceptionandpossiblyduetosubjectivepatientfac- tors. Usually, I use 5/0 or 6/0 fissure material in augmentation surgery, whereby the Bio-Gide mem- brane,whichIamusingoftentimes,isavailableinthe dimensions 13x40 mm, 25x25 mm or even 30x 40 mm. Thus, the operator has an option for almost everyindicationandcanchoosethemosteconomic, i.e. most priceless option, which is also in the pa- tient’s interest. I must not forget to point out the remarkably good material properties of this membrane regard- ing tensile strength and foldability, which is not granted for every competitor. Thus, I often perform external sinus lift operations with very small lateral bone space, whereby I fold the membrane—in the same way as a model ship is inserted into a bottle— and then unfold it before it becomes saturated with liquid. In this way, the Schneider’sche membrane in theparanasalsinusisstabilisedforalongtimeanda perforation of undesired dislocation of augmenta- tion material is prevented successfully (Liebaug & Wu, 2011). _Conclusion Without the application of augmentative treat- ment methods—particularly the membrane pro- tectedboneregeneration—Iwouldhavehelpedonly few patients to get a fixed or high-quality implant- supported dental prosthesis in the past 20 years. In my therapy concept, a successful dental implantol- ogy begins already or at best with the socket preser- vation and ridge preservation simultaneously to the tooth removal. But these measures do make sense when afterwards a conventional prosthetic rehabil- itation with fixed bridges or combined fixed and re- movable telescopic or bed-load prosthesis will be planned. The application of barrier membranes— particularly collagen membranes—has developed to a very reliable and successful clinical routine proce- dureforallthosecaseswhereanadequatebonema- terialinheightandwidthshallbegeneratedforlater therapy measures._ Fig. 7_The Bio-Guide-membrane can be adapted well under the surrounding periost without absorbable pins and saturates itself with the patient’s blood from the edges. Fig. 8_The membrane is completely soaked with the patient’s blood and can be plastically covered by mucoperiosteal flaps. Fig. 9_Complete, primary wound closure from buccal. Fig. 10_Also the occlusal view and examination confirms the de-energised closure of the mukosa which is not unimportant for the healing process; due to flap advancement, the vestibulum could be saved well. Fig. 9 Fig. 10 Jiaoshou (Prof.) Dr Frank Liebaug Scientific Director of Ellen-Institute, German Institute for Dental Research and Education Professor University Shandong,China Arzbergstr.30,98587 Steinbach-Hallenberg Germany Tel.:+49 36847 31788 www.zahnarzt-liebaug.de www.ellen-institute.com _contact implants Fig. 7 Fig. 8