Abstract:
Introduction. In cases of moderate lateral atrophy of the crest bone splitting, sausage technique
or other grafting procedures like bone blocks are recommended. However, in case of ridge
expanding, subcrestal positioning of implants is necessary while in case of bone blocks the terms
of rehabilitation are longer.
Aim of the study. To evaluate the possibility of contour buccal grafting with simultaneous
implants placement in one and two surgical steps.
Materials and methods. The study was performed on 5 patients in which 10 implants were
installed in one and two surgical steps in the lateral sides of the jaws. Due to horizontal bone
atrophy, grafting procedures were performed with simultaneous implants placement. In one case,
collagen membrane was used to isolate the grafting material and non submerged technique was
applied for implant. In the others, implants were installed in one and two surgical steps with
grafting material (collagen and hidroxyapatite) without collagen membranes. At the end of
healing, for the implants installed in two-steps, the second stage was performed and the
evaluation of the grafted volume was appreciated. In cases with one step protocol, the level of
buccal soft tissues was appreciated.
Results. All implants successfully integrated. In one case, solitary graft particles were observed
in the soft tissues. The augmented sites shrank insignificantly, and a good profile from buccal
site was observed in all the cases. No significant effect was observed in the usage of collagen
membrane as well as in one or two-steps protocol.
Conclusions. The usage of contour grafting in case of implants placement in posterior sides of
the jaws seems to be a good method of augmentation. In case of a good periosteum, the collagen
membrane isolation is not mandatory. Due to the lack of difference between one step and two
steps protocol, the one step placement is more favorable because of the reduced number of
surgeries and a mature biological width at the end of healing period. Further studies are
necessary to appreciate indications and contraindications for such kind of augmentation.
