IM0210

implants2_2010 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 neces- sary 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 cyanoacrylate. Hereby the patient only incurs a microscopic extraction defect. Figs. 16 & 17_The soft tissue in the implant region is closed with ab- sorbable suture material. The neigh- bouring teeth 43,42,32,33 are lingually cauterised. Figs. 18 & 19_Insertion of a Mary- land provisional prosthesis, directly after the augmentative-implantologi- cal intervention. Fig. 20_ DVT of excavation defect. was 2/3 exposed on its vestibular side in region 031. Both implants were primarily stable. After measuringthemissingbonevolume,astabincision was made in the right retromolar. Then a conven- tional implant drill was driven through the gums and drilled precisely 9 mm deep. When withdraw- ingthedrillthebonemealwasalreadyabletobere- tained. Additionally further spongiose bone was extracted with a mini-excavator. Thetransplantbonewasabletobeadsorbedinto theimplantbodyinanidealmanner.Finallyathing collagenmembranewasappliedforcompletecov- erage. The soft tissue defects were closed with ab- sorbable materials. The stab incision in the retro- molar was glued with cyanoacrylate. In regions 031/041 the wound closure was carried out using absorbable suture material and horizontal mat- tress stitches. Finally as a provisional restoration a Maryland temporary prosthesis was affixed, which addition- ally ensured a good soft tissue stabilisation. A dig- italvolumetomography(DVT)wasproducedinor- der to evaluate the removal defect and document the augmentative result. _Summary Autologous bone grafting represents the gold standardinaugmentationsurgery.Particularlywith implant operations it is often only shown intraop- eratively that a small quantity of autologous bone is needed for augmentation. In this situation quick reaction is often indicated. The retromolar space is frequented most often for this purpose. As the pa- tient should have the least possible discomfort due to the bone extraction, minimally invasive proce- dures are the means of choice. Thetechniquepresentedaboveisanewmethod which is impressive due to its minimally invasive and simple characteristics. The shown procedure is especially ideal for augmentation planning with volumes up to 0.5 mg. Of course larger bone vol- umescanalsobeextractedusingthisminimallyin- vasivemethod.Softtissuescanbecloseddiscreetly andsothattheyarehardlynoticeabletothepatient usingadhesivetechniques.Minimallyinvasivepro- cedures in implantology can be perfectly planned andexecutedbyincludingmodern3-D-diagnostics (DVT)._ Dr Dr Steffen Hohl DIC Dental Implant Competence Estetalstr.1 21614 Buxtehude,Germany www.dr-hohl.de Dr Anne Sophie Brandt Petersen Tandlaegerne i Kogade Kogade 4 6270Tonder,Denmark www.dentist.dk _contact implants Fig. 22 Fig. 19 Fig. 20 Fig. 21