Submerged vertical bone augmentation of supraosseous peri-implant defects

Although most peri-implant lesions feature a combined defect configuration that involves both supra- and infraosseous components, regenerating the supraosseous part is considered the optimal approach, albeit a challenging one, and often requires vertical bone augmentation. This report provides a detailed description of submerged membrane techniques for vertical bone augmentation around supraosseous peri-implant defects. Cases involving different types of membrane (both resorbable and non-resorbable) with or without the use of bone graft are presented. In the first case, the patient had a mild supraosseous defect that was managed using the sausage technique with collagen matrix soaked with human recombinant bone morphogenetic protein-2. In cases two to five, titanium-reinforced dense polytetrafluoroethylene membranes were employed.

The reconstruction of supraosseous peri-implant defects is technique sensitive but can be achieved when adhering to the principles of space maintenance and submerged healing.