Augmentation I

Bone augmentation serves three main objectives: firstly, it improves function by allowing the implant to be placed in the optimal prosthetic position and axis. Secondly, bone augmentation optimizes aesthetics, since the position of the implant—particularly the bone shoulder on the implant—forms the base for soft tissue. Thirdly, it improves the prognosis of the implant. Bone augmentation enables the implant to be surrounded by solid bone on all sides, thus preventing downgrowth of the junctional epithelium and pocket formation, and permitting selection of sufficiently stable implant hardware. Module 5.1 describes patient selection for augmentation surgery, the SAC classification system, and the consequences and severity grades of alveolar ridge atrophy. Bone tissue formation and the biology of bone healing are described, including a discussion of these processes in the presence of various types of defects. The chapter on the value and use of autologous bone grafts in combination with bone substitute material and other biomaterials is of particular importance.

This module addresses the practical aspects of intraoral bone augmentation. Bone harvesting techniques are presented, and the selection of intra- and extraoral donor sites for autologous bone grafts is addressed. Flap design for bone augmentation surgery and soft tissue management is described. This module provides the dental surgeon with practical clinical tips for successful bone regeneration. Fundamental surgical techniques are explained, such as fixation of bone grafts using osteosynthesis screws. An animation portrays the clinical procedure of guided bone regeneration (GBR) using barrier membranes. The single-stage immediate implant insertion approach with simultaneous augmentation is compared to the staged procedure. Complications and their clinical management are discussed, including anti-infective preparation according to the four-level concept.