THE “UMBRELLA TECHNIQUE”: A NEW PROCEDURE FOR HARD AND SOFT TISSUE AUGMENTATION IN THE VERTICAL DEFECTS OF THE JAWS

Abstract

Objective. To propose a new procedure to restore both hard and soft tissues in the vertical defects of the jaws.
Methods. A tenting screw was inserted in a mandibular vertical bone defect in the molar region. A titanium mesh was trimmed and stabilized to a tenting screw with its cover screw. The mesh was shaped not to cover the whole defect but just the area above the tenting screw, like an umbrella, with the aim to help a resorbable membrane not to collapse over the defect. A collagen membrane, stabilized with tacks both on the lingual and buccal side, covered the defect, filled with particulate autogenous graft mixed with a xenograft in a 1:1 ratio. After 3,5 months, a split thickness flap was raised, the mesh and the tenting screw were removed, a palatal graft was harvested from the palate and stabilized with sutures on the recipient site to augment the band of keratinized tissue. Nine months after bone augmentation the site was re-opened for implants and healing abutments application.
Results. At implant insertion stage, both hard and soft tissue grafts were completely healed and matured.
Conclusion. This procedure shortens the overall treatment time, inserting the implant in matured and stable augmented hard and soft tissues.