1.0Zerodonto | Dentistry in Bloghttps://www.zerodonto.com/enrich600338<blockquote class="wp-embedded-content" data-secret="wA4qiDr9Gc"><a href="https://www.zerodonto.com/en/2019/10/spal-technique/">Sub-Periosteal peri-implant augmented layer (SPAL) technique for peri-implant bone augmentation</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://www.zerodonto.com/en/2019/10/spal-technique/embed/#?secret=wA4qiDr9Gc" width="600" height="338" title="“Sub-Periosteal peri-implant augmented layer (SPAL) technique for peri-implant bone augmentation” — Zerodonto | Dentistry in Blog" data-secret="wA4qiDr9Gc" frameborder="0" marginwidth="0" marginheight="0" scrolling="no" class="wp-embedded-content"></iframe><script> /*! This file is auto-generated */ !function(d,l){"use strict";l.querySelector&&d.addEventListener&&"undefined"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!/[^a-zA-Z0-9]/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret="'+t.secret+'"]'),o=l.querySelectorAll('blockquote[data-secret="'+t.secret+'"]'),c=new RegExp("^https?:$","i"),i=0;i<o.length;i++)o[i].style.display="none";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute("style"),"height"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):"link"===t.message&&(r=new URL(s.getAttribute("src")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener("message",d.wp.receiveEmbedMessage,!1),l.addEventListener("DOMContentLoaded",function(){for(var e,t,s=l.querySelectorAll("iframe.wp-embedded-content"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute("data-secret"))||(t=Math.random().toString(36).substring(2,12),e.src+="#?secret="+t,e.setAttribute("data-secret",t)),e.contentWindow.postMessage({message:"ready",secret:t},"*")},!1)))}(window,document); //# sourceURL=https://www.zerodonto.com/en/wp-includes/js/wp-embed.min.js </script> https://www.zerodonto.com/en/wp-content/uploads/2019/09/spal-technique.jpg959536A 71 yo male patient, non smoker and sistemically healthy required a fixed implant-supported rehabilitation in the posterior left mandible. Teeth in position 3.5-3.7 were extracted 6 months before the screening visit and a socket preservation procedure was performed. Clinical and CBCT evaluation revealed a thin bucco-lingual dimension of the bone ridge, insufficient to place implants in a prosthetically driven position. Treatment plan required the placement of 3 implants in position 3.5-3.6-3.7 by mean of the Sub Periosteal Peri-Implant Augmented Layer (SPAL) technique to simultaneously augment the thickness of the buccal bone plate at the time of implant in position 3.5 – 3.6. A split-thickness, crestal incision was performed in the region 3.5-3.7. A vertical releasing incision was made distal to 3.4. A split thickness flap was then raised using a 15C blade thus creating two distinct layers. A external tension free layer, namely the mucosal layer, and an internal layer attached to the bone ridge, namely the periostal layer. A full thickness flap was elevated on the lingual aspect. Periosteal layer was then detached from the bone ridge by mean of a crestal incision reaching the bone and using microsurgical periosteal elevator (PTROM, Hu Friedy, Chicago, Illinois) and tunnelling […]