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Bone ring technique
Pilot drill
Ring bed preparation with a trephine
Ring bed preparation with a planator
Ring length adjustment with a diamond disc
Implant drill through the inserted bone ring
Implant insertion through the bone ring
Sharp edge smoothening
Covering with cerabone®
Covering with pinned Jason® membrane
Tension-free wound closure
Vertical augmentation: Preparation of ring bed in atrophic mandibula (third quadrant)
Planning the surgery with CoDiagnostix® for Straumann® Guided Surgery
X-ray scan of clinical situation
Severe periimplantitis at tooth 15 with bone loss up to 1/3 of the implant
Initial situation: bone loss due to lack of physical load of bridge retained region 11
Initial situation: single tooth gap in regio 22
Clinical situation: 71-old patient with atrial fibrillation and Warfarin medication
Initial situation pre-op: Central incisors with mobility 3
X-ray scan reveals initial situation with maxillary bone height in regio 15 of 1.5 mm
Initial situation: X-ray scan reveals eggshell thin sinus floor (1-3 mm) on both sites of the maxilla; green areas indicate the planned maxgraft® bonerings and red areas the planned implants
Initial situation: missing incisor with loss of buccal wall
Initial situation 57-year old female patient. X-ray scan reveals severe bone loss due to inflammation in region 13. Treatment plan was extraction of teeth 13 and 14 and augmentation after healing.
X-ray scan: initial situation loss of two wall bony defect with loss of buccal and lingual lamella
Initial presentation of failing post retained crown with previous history of failed apicectomies and amalgam tattooing and scar tissue
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botiss offers prefabricated allogenic bone rings, whose use minimizes the risks associated with the harvesting procedure and reduces the post-operative pain as well as the risk of infection and operation time. maxgraft® bonering is a sterile, highly safe allograft product derived from the femoral heads of living human donors. The prefabricated rings can be placed press-fit into the prepared ring bed.
In addition, botiss offers a surgical kit that provides all necessary instruments for the bone ring technique. The first step of the surgical procedure is the determination of the position of the implant using the pilot drill; the ring bed is then prepared with a trephine. Subsequently, the use of a planator enables an even paving of the local bone to achieve an optimal contact with maxgraft® bonering as well as the removal of the cortical layer, which improves the graft revascularization. With maxgraft® bonering, a vertical bone augmentation of 2–3 mm above bone level can be easily performed. For the augmentation of a severely atrophic mandibular, a width of the ridge (in the case of a parallel-walled ridge) of at least 4 mm is necessary for a successful application of maxgraft® bonering. The technique is also applicable for a one-stage sinus lift with minimal maxillary bone height. In this case, the implant is fixed in the sinus with the allogenic bone ring; these are held together with a membrane screw.
It is recommended to fill the residual defect volume with a slowly resorbable bone regeneration material (i.e., cerabone®) and to cover the augmentation site with a collagen membrane. The pericardial Jason® membrane is an ideal solution in such a situation due to its long-term barrier function. A tension-free suturing of the operation site minimizes the risk of tissue perforation and/or graft exposure.
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