Dr. Ernst Fuchs

Numerous studies focus on the cell-biology, molecular biology and the biochemical influences of the bone-healing process by defining the BMU (Beta-TGF and BMP-2; = bone morphogenetic units), but neglect the local mechanical influences. Through this atraumatic procedure by minimal-invasive spreading of the alveolar ridge with erection and rotation of the nutritive-supplied and basal-connected cortical plate, a “mechanical shell” and therefore a “guideline” for the new-regenerative bone can be achieved. These mechanical givens seem to interfere with the osteogenetic cells in a positive way and seem to be the ruling force for the new-regenerative bone. The atraumatic procedure, affiliated with the protection of the periost and the surrounding tissue, and carried out by two intern osteotomies – like a “predetermined breaking point” – decisively influences the success of the new-regenerative bone. Usually the periost is after a full thickness-flap procedure and an osteotomy not functionally intact prior to six weeks. This can be avoided by the horizontal control procedure. (“Form follows function” = Wolff’s law)

An ossification can be better carried out, if the cortical plate stays stabilized and micro-movements are avoided. Oral implants can be incorporated in order to keep the spreading gap open for stabilization and splint (as a space-holder). The healing process can be achieved by an open granulation or, if desired, a primary wound closing can be carried out by mobilizing the lingual mucosa.