Step-by-step procedure of the bone ring technique

Step 1)
Expose removal site on the chin and premark with the trephine drill.
Step 2)
Drill the ring opening in the bone as long as the transplant is still firmly anchored in the bone.
Step 3)
Prepare the final depth of the bone ring with the trephine drill.
Step 4)
Detach cancellous bone from the contralateral bone and remove ring.
Step 5)
Removed bone ring with cortical and cancellous bone.
Step 6)
Prepare defect on the receptor site for fitting the transplant using the trephine drill.
Step 7)
Insert bone transplant and prepare the implant bed.
Step 8)
Insert the implant subcrestally through the bone ring.
Step 9)
Fix the transplant and implant using the membrane screw.
Step 10)
Fill the remaining defect volume with autogenous bone chips and bone regeneration material.
Step 11)
Cover recipient site with collagen membrane.
Step 12)
Suture soft tissue tension-free.
(Photos: Dr. Orcan Yüksel, Frankfurt/DE und
Dr. Bernhard Giesenhagen, Melsungen/DE)

The following factors require special attention in augmentation with autogenous bone ring transplants:

  • The receptor site must contain as many vital cells as possible to ensure optimal revascularization of the transplant.
  • Sufficient local bone is required to anchor the implant for primary stability.
  • Immobile positioning of the transplant is essential.
  • The transplant must be contoured with slowly resorbable bone regeneration material to combat any volume loss.
  • Safe and tension-free wound closure is a prerequisite for trouble-free healing.

ANKYLOS® fulfils all the requirements for the bone ring technique as an implant system:

  • Parallel-wall implantat design
  • No thread in the region of the implant neck
  • Progressive thread in the apical region for sufficient primary stability in the cancellous bone.
  • Implant-abutment-connection free of movement and bacteria-proof
  • Membrane screw to fix the transplant and implant