Tenting: Simple Predictable Approach to Graft for Width

This is my case, could have written it more clearly. Obviously, the photo is just an example of what the screw looks like, not this case. I did wonder what others thought of 3.5s in molar sites? Ever case has to considered individually, and I could see some exceptions, but in general 4.3 is my smallest molar size, thoughts?

My general philosophy is to over-engineer in as many cases as possible. Sometimes this is either not possible or not practical (as you say each case has to be considered individually). However rule of thumb is that it will not break if it is too strong, but it may break if it is not strong enough.

What type of membrane are you using and are you fixating it? Also what bone graft are you using?

I used to tack with BioHorizons auto tack before I used the tent screws, but the screw keeps everything in place and I don’t find tacking is necessary.

Whenever I see articles about bone augmentation and specifically Tent Screws my interest is perked. I'm not sure if it is intentional or not but the author of this question appears to state that the photo of the KLS Martin tent screw may be his of his case or one similar to it. The KLS Martin Tent Screws were developed my me and are marketed through them. (RosenlichtTent Screws). Tenting procedures and tent screws have been around a long time and is an ahas been a very predictable procedure for augmenting both with and height. It is somewhat technique sensitive and graft type specific depending on the host, type of defect and recipient site preparation. The Tent Screws come in 3 different smooth shaft lengths of 3, 5 and 7 mm with 4 mm of thread to engage the bone without entering into the medullary space and injuring underlying structures. What makes this Tent Screw effective is the wide head that help maintain the space created and not allow the overlying soft tissue to collapse and perforate exposing the graft. We typically can achieve 3 to 5 mm of augmentation . At times we also use a resorbable or non resorbable membrane to aid in tissue stability. Non tension water tight closure is imperative and often time we make remote incisions so as not to close over the graft. Based on the patient, graft size and materials used we usually wait 3 months for maturation. In unique situations we have done the augmentation along with simultaneous 2 stage implant placement. To answer the question of 3.5 for molars it would be my preference to augment and place a larger diameter implant for a better emergence profile. If I were to use a small diameter implant and there was adequate spacing I would consider two 3.0 or 3.5 implants and make bicuspid size restorations allowing for better hygiene and support of the restoration, I have had implant fractures and perio issues when large restorations are place on small diameter implants. Anyone interested in seeing this case in a power point or also has any question feel free to contact me.

Joel, how can I contact you for the power point presentation.

Maybe you can post the case here? No, not implying it was my case, just a nice clear example. Should I be sure to say it's not mine in a case like this?

Only 3 months of healing huh Joel? Where can I read more about the work you did? I'm waiting 6-8 months. Does your healing time vary with age or any other factors? I'm using Lifenet mineralized Cortical/Cancellous 50/50, plus 10% of host bone collected locally and patients mixed with patients blood. What did you generally use?