SURGICAL INSTRUMENTS Alternatively, as demonstrated here, fixation can also be applied in the soft, mucous region, so that the procedure can proceed without flap removal towards lingual or palatinal. Initial pilot drilling through the transplant is carried out as soon as the bone transplant is fixated on the highly atrophic site, where it remains secured through the entire drilling procedure and the insertion and fastening of the osteosynthesis screws. This technique allows safe and predictable bone transplantation, as required for the long-term stability of implant-based restitutio ad integrum for the patient. Figure 1: Severe alveolar crest atrophy precluding primary implant insertion - a block transplant and a sinus grafting procedure are necessary. Figure 4: Fixation of the bone transplant with the bone fixation forceps before drilling and screwing Figure 7: ...which is safely fixated during the whole drilling and screwing procedure Figure 3: Fixation of the bone transplant - watch here the fixation of the forceps (Aesculap AG, Germany) on palatal mucosa. Figure 2: Grafting of the bone transplant - here from the retromolar donor area. Figure 5: Drilling through the bone transplant while the transplant is fixated with the bone fixation forceps. Figure 8: Postoperative view of bone block osteosynthesis combined with... Figure 6: Immediate insertion of the osteosynthesis screws through the transplant... Figure 9: ... a simultaneous sinus lift procedure with autogenous bone particulated in the bone mill and alloplastic material. Page 2/3 Orders 1 3 0 0 6 5 8 8 2 2 9