Horizontal bone augmentation and simultaneous implant placement using periosteal pocket flap technique - two stage surgical approach

CBCT scan of the initial situation displays horizontal bone deficiency of the alveolar ridge

Alveolar ridge after osteotomy preparation for a implant and cortical bone perforations

Implant placement. Note exposed implant threads and absence of the sufficient amount of buccal peri-implant bone

The membrane Evolution has been adapted and stabilised at the top with the cover screw of the secondary prosthetic platform

Mixture of the Gen-Os® a and autologous bone

Bone augmentation with Gen-Os®. Second layer of the membrane Evolution. The flap design results in a periosteal pocket formation, which allows that the graft-membrane complex was covered with periosteum and stabilised with periosteal sutures

Suturing

Second stage surgery. Situation after 5 months of healing

Comparison

Soft tissue augmentation using connective tissue graft for a buccal and lingual flap

Soft tissue reconstruction with anatomical healing abutment and 3 pieces of connective tissue graft

Emergence profile after 4 weeks

Definitive all-ceramic restoration

Definitive all-ceramic restoration and natural tooth-like gingival contour