In the first case, two bar-supporting implants have an advanced, combined (supra- and intraosseous) defect configuration with vestibular dehiscences and a supracrestal exposed screw thread (>1 mm). In such cases, after completely removing the granulation tissue, we start out by performing plastic surgery on the implant to smooth the implant body in the supracrestal and buccal defect region. The portions of the implant surface facing the defect are structurally preserved and decontaminated (e.g., with a curette, Er:YAG laser and sterile saline solution).
The intraosseous defect components are then augmented with a slowly resorbing bone replacement material. This is covered with a collagen membrane before the soft tissue flap is adapted tightly around the implants.
The second case involves circumferential intraosseous defects with a supracrestal component (<1 mm) on two adjacent implants. Such defects can be regenerated using bone grafting without implantoplasty.