Posterior Mandible Vertical Augmentation using d-PTFE Membrane

This lady had missing lower left molars for a few years and had a chrome unilateral free end saddle denture. There are several options to treat patients like this, including:

1. Short implants (in this case it is almost impossible)

2. Nerve lateralisation technique (more bone loss during the process, long term nerve injury, Lack of good soft tissue around implants)

3. Vertical Augmentation (failure rate).

After discussing the options, we agreed to perform vertical bone augmentation, implant placement, and soft tissue surgery.

I strongly believe good connective tissue is very important around implants, especially when we perform any kind of bone augmentation. When performing posterior mandible vertical augmentation, flap advancement to accommodate the new vertical height is vital. Lingual flap technique has several steps to understand and perform. When done well the release and advancement is enormous. Literally you can close the graft with just the lingual flap. Membrane adaptation is important for a successful outcome.

Materials used: Cytoplast, Bio-oss, Bio-gide, Messinger master pins, bone mills, Dentsply implants.