00:00 minStarting with the intervention in the left mandible

 0:18 Peri-implantitits at implants in left mandible

0:45 Explantation of the implants with the bony lid method

1:19 Replacing ot the bone block

1:39 Re-entry

1:52 Semilunar tunnel technique with partial thickness flap

02:15 min

Safe Bone harvesting from retromolar area

2:56 Collecting blood for sinus floor elevation with bone bone substitutes

3:17 Splitting of the block

3:25 Collecting bone particles from retromolar area

4:01 Removing the sharp edges from the block

4:30 Placing the occlusal bone shell

4:52 Filling the space with pure autogenous particles

5:20 Fixing the lateral bone shell with osteosynthesis screws

5:46 Closure of semilunar tunnel technique

06:01 min

Crestal incision in right maxilla

6:14 Approach sinus window with round diamond bur

6:28 Elevation of the Schneiderian membrane

6:38 Layering concept: Starting with the bone substitutes, soaked in intraorally collected blood

6:52 Template for correct implant position

6:57 Using trephine bur for collecting autogenous bone cylinders (bone core technique according to Prof. Fouad Khoury)

7:23 Use of the Osteotomes for increasing the primary stability of the implant

7:26 Placing the implants (Ankylos Dentsply Sirona)

7:47 Filling lateral defect with pure autogenous bone particles

7:56 Fixing the autogenous bone shell laterally with osteosynthesis screws

8:07 Removing the sharp edges from the bone shell

8:22 Filling the crestal space with pure autogenous bone particles according to the Layering concept

8:28 Closure of the Sinus window with Titanium membrane

8:37 Postoperative x-ray after vertical bone augmentation according to BBA Concept and Khoury technique

08:41 min

Preparation of a palatal pedicled flap from the right palate

9:00 Bringing the palatal pedicled flap in the right position

9:11 Closure of the right maxilla

09:29 min

Re-entry in the left mandible with Kazanjian Vestibuloplasty for creating an new vestibule

9:41 Starting with partial thickness flap

9:59 No resorption of the augmented bone

10:18 Removing the osteosynthesis screws

10:24 Using the trephine bur for collecting bone cylinder for histology

10:48 Collecting autogenous bone chips by using drill without irrigation

11:05 Placing of the implants

11:21 Kazanjian Vestibuloplasty- separating the periosteum from the muscle fibres

11:28 Closure of the Kazanjian vestibuloplasty

11:42 min

Second stage surgery with apical repositioned flap

12:09 Preparation of small Palacci flap from the palatal side

12:17 Removing the titanium membrane

12:40 Removing the cover screws via small stitch incision

12:47 Placing the healing abutments

12:53 Suturing of the mucosa on the underlying periosteum

13:20 min

Second stage surgery in mandible with small stitch incision

13:28 Placing the healing abutments

14:00 Impression taking with splinted impression (pattern resin)

14:13 Planing of the CAD CAM fabricated abutments in maxilla

14:33 The final restoration of the maxilla in laboratory- screw retained and splinted metal framework of the implant- supported bridge

15:15 The splinted and screw retained framework of the bridge in mandible

15:33 Intraorally placed implant supported bridge with typical surrounding scare tissue in the peri-implant area

BBA Video Tutorial 1.1 -
Vertical augmentation with Semilunar Tunnel Technique in left mandible

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