1) Edentulous area of two missing teeth is being prepared for future placement of dental implants with a lateral window<unk> ; incisions into the soft tissue are shown here. 2) The soft tissue is flapped back to expose the underlying lateral wall of the left maxillary<unk> . 3) The bone has been removed with a piezoelectric instrument, exposing the underlying Schneiderian membrane, which is the lining of the maxillary<unk>  cavity. 4) Through careful instrumentation, the membrane is carefully peeled from the inner aspect of the<unk>  cavity. 5) The membrane has been reflected from the internal aspect of the inferior portion of the<unk>  cavity; one can now visualize the bony floor of the<unk>  cavity without its lining membrane (note the triangular ridge of bone within the<unk> , known as an Underwood's septum). 6) The newly formed space within the bony cavity of the<unk>  yet inferior to the intact membrane is grafted with human cadaver allograft bone. The floor of the<unk>  will now be roughly 10mm or so more superior than it was before, providing enough room to place dental implants into the edentulous site. Prior to undergoing<unk>  augmentation, diagnostics are run to determine the health of the patient's<unk> es. Panoramic radiographs are taken to map out the patient's upper jaw and<unk> es. In special instances, Cone beam computed tomography is preferable to measure the<unk> 's height and width, and to rule out any<unk>  disease or pathology. There are several variations of the<unk>  technique. Traditional<unk>  Augmentation or Lateral Window Technique There are multiple ways to perform<unk>  augmentation. The procedure is performed from inside the patient's mouth where the surgeon makes an incision into the gum, or gingiva. Once the incision is made, the surgeon then pulls back the gum tissue, exposing the lateral boney wall of the<unk> . The surgeon then cuts a "window" to the<unk> , which is exposing the Schneiderian membrane. The membrane is separated from the bone, and bone graft material is placed into the newly created space. The gums are then sutured close and the graft is left to heal for 4–12 months. The graft material used can be either an autograft, an allograft, a xenograft, an alloplast (a growth-factor infused collagen matrix), synthetic variants, or combinations thereof. Studies indicate that the mere lifting of the<unk>  membrane, creation of a void space and blood clot formation might result in new bone owing to the principles of guided bone regeneration. The long-term prognosis for the technique is estimated to 94%. Osteotome Technique As an alternative,<unk>  augmentation can be performed by a less invasive osteotome technique. There are several variations of this technique and all originate from the original technique of Dr. Tatum, first published by Dr.s Boyne and James in 1980. Dr. Robert B. Summers described a technique that is normally performed when the<unk>  floor that needs to be lifted is less than 4 mm. This technique is performed by flapping back gum tissue and making a socket in the bone within 1–2 mm short of the<unk>  membrane. The floor of the<unk>  is then lifted by tapping the<unk>  floor with the use of osteotomes. The amount of augmentation achieved with the osteotome technique is usually less than what can be achieved with the lateral window technique. A dental implant is normally placed in the socket formed at the time of the<unk>  procedure and left to integrate with bone. Bone integration normally lasts 4 to 8 months. The goal of this procedure is to stimulate bone growth and form a thicker<unk>  floor, in order to support dental implants for teeth replacement.<unk>  dimensions and shape significantly influence new bone formation after transcrestal<unk>  floor elevation: with this technique, the regeneration of a substantial amount of new bone is a predictable outcome only in narrow<unk>  cavities. During presurgical planning, bucco- palatal<unk>  width should be regarded as a crucial parameter when choosing<unk>  floor elevation with transcrestal approach as a treatment option. Dr. Bruschi and Scipioni described a similar technique (Localized Management of<unk>  Floor or L.M.S.F.) that is based on a partial thickness flap procedure. This technique increases the malleability of the crestal bone and uses not the bone directly below the<unk> , but rather the bone on the medial wall, and thus can be used in more extreme cases of bone resorption that would normally need to be treated with the lateral wall technique. The healing period is reduced to 1.5 to 3 months. Recently an electrical mallet has been introduced to simplify the application of this and similar techniques.
Sinus lift
Forehead lift
Concussion
Vocal rest
Angellift
Pulp capping
Keidel vacuum
Binasal occlusion