Augmentation Techniques – the Basis of Aesthetic

Bone harvesting from the peri-implant environment To augment minor bone defects, it is frequently suffi- cient to harvest autologous bone from the peri- implant environment (Figures A1–A4). Autologous grafting material should be placed such that direct contact with the implant surface is established. To avoid premature resorption of the augmented area, an additional layer of resorbable xenogenous materi- al (e.g. Bio-Oss, Geistlich) is applied and covered with a membrane. Using a resorbable collagen membrane (BioGide, Geistlich) for coverage will prevent disloca- tion of the augmented bone during the healing phase and guard against soft-tissue ingrowth into the defect (Figure A4). Bone harvesting from the tuberosity region The surgical procedure of harvesting autologous bone from the tuberosity region is simple and involves only minor postoperative trauma. Note, however, that the deposition of fat in the tuberosity region may be significant depending on the patient’s age and individual anatomy, which will reduce the osteogenic properties of the harvested bone. The material is collected using a chisel and small trephine burs or simply with a Luer rongeur. Care must be taken to spare the palatal wall of the tuberosity to avoid structural alterations in that region (Figures T1–T4). EDI Case Studies 7 Fig. T1 Bone harvest- ing from the tuberosity with a chisel. The palatal wall is spared. Fig. T2 Bone harvest- ing from the tuberosity with a Luer rongeur. Fig. T3 Bone harvest- ing from the tuberosity with a small trephine. Fig. T4 Autologous material har- vested from the tuberosity with a trephine cutter.