{"version":"1.0","provider_name":"Zerodonto | Dentistry in Blog","provider_url":"https:\/\/www.zerodonto.com\/en","title":"Sub-Periosteal peri-implant augmented layer (SPAL) technique for peri-implant bone augmentation | Zerodonto | Dentistry in Blog","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"OYVxi7RRv2\"><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=OYVxi7RRv2\" width=\"600\" height=\"338\" title=\"&#8220;Sub-Periosteal peri-implant augmented layer (SPAL) technique for peri-implant bone augmentation&#8221; &#8212; Zerodonto | Dentistry in Blog\" data-secret=\"OYVxi7RRv2\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script>\n\/*! This file is auto-generated *\/\n!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);\n\/\/# sourceURL=https:\/\/www.zerodonto.com\/en\/wp-includes\/js\/wp-embed.min.js\n<\/script>\n","thumbnail_url":"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2019\/09\/spal-technique.jpg","thumbnail_width":959,"thumbnail_height":536,"description":"A 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 &#8211; 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 [&hellip;]"}