Staged SFE is performed; following a 3-month-long healing period, bone core biopsy samples are harvested from the augmented bone, and dental implants are placed.

Staged SFE is performed; following a 6-month-long healing period, bone core biopsy samples are harvested from the augmented bone, and dental implants are placed.

Patients rinse with 0.2% chlorhexidine solution for one minute before surgery. Under local anesthesia, a mucoperiosteal flap is raised from a midcrestal incision and two relieving incisions. Lateral window osteotomies are carried out using diamond burs. The Schneiderian membrane is carefully elevated and the synthetic bone graft material (Bond Apatite, Augma Biomaterials, Cesarea, Israel) (2-3 cm3) is packed in the defect with light force. The buccal flap is then mobilized to allow tension-free primary closure. The margins are stabilized with single interrupted sutures. Antibiotics (1 g amoxicillin-clavulanate twice a day for 5 days, or in case of side effects or known allergy to penicillin, 300 mg clindamycin 4 times a day for 4 days), anti-inflammatory drugs (50 mg diclofenac 3 times a day for 3 days), and chlorhexidine mouthwash (twice a day for 21 days from the first day after surgery) are prescribed. Suture removal takes place after 10 days.

The SFE surgery is successful if no inflammatory complications occur in the 3- or 6-month-long healing period and the bone volume is sufficient for dental implant placement.

According to The International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference.

Success (optimum health)

1. No pain or tenderness upon function
2. 0 mobility
3. less than 2 mm radiographic bone loss from initial surgery
4. No exudates in the patient's history

II. Satisfactory survival

1. No pain on function
2. 0 mobility
3. 2-4 mm radiographic bone loss
4. No exudates in the patient's history

III. Compromised survival

1. May have sensitivity on function
2. No mobility
3. Radiographic bone loss of more than 4 mm (less than1/2 of the length of the implant body)
4. Probing depth more than 7 mm
5. May have exudates in the patient's history

IV. Failure (clinical or absolute failure)

Any of the following:

1. Pain on function
2. Mobility
3. Radiographic bone loss of more than 1/2 length of the implant
4. Uncontrolled exudate
5. Implant no longer in mouth

Prostheses with four or fewer complications (screw loosening, decementation, chipping) that could be treated chairside.

The percentage of residual bone graft particle-area measured on the representative sections prepared from the bone core biopsy samples. Unit: percent (%)