In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin gingival morphotype A and 35% (n = 6) of the patients a thick gingival morphotype B. Fifty-seven percent (n = 12) of the augmented regions were located in the mandible and 43% (n = 9) in the maxilla. The length of the defects ranged from a minimum of one to a maximum of nine teeth (mean 3 ± 2 teeth). A mid-crestal incision was performed in 11 augmentation sides (52%), and a modified poncho incision was applied in 10 augmentation sides (48%). In 19 augmented sites, a mixture of deproteinized bovine bone mineral and autologous bone was used. In two augmented sites, autologous bone alone was inserted. In two cases, no membrane for covering the TM was used, in six cases, a resorbable collagen membrane, and in 13 cases, a double layer of collagen membrane, and PRF membranes were inserted.

In all cases, the individualized TM could easily be placed into the planned area of augmentation. The postoperative healing was uneventful in 14 cases (67%) during the follow-up time of 6 months until reentry. In seven cases (33%), an exposure of the TM after a period ranging from 5 to 12 weeks from first-stage surgery was seen. All the dehiscences appeared in the area of the suture. Patients with TM exposure were treated with chlorhexidine mouthwash rinse. The premature removal of the TM after exposure was necessary in none of the cases, and all the preoperatively planed implantations could be carried out. Therefore, exposure of the TM had no negative influence on the clinical outcome of the augmentation procedure and success of the bone grafting procedure was 100%. Exposure rate in augmentations performed with mid-crestal incisions (45.5%) was higher than in augmentations performed with a modified poncho incision (20%), however, not statistically significant (p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on exposure rates (p > 0.05). Comparing the preoperative and 6-month postoperative cone beam computed tomography (CBCT), a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm was achieved (Fig. 10). After a mean follow-up of 12 ± 6 months after second-stage surgery, none of the 44 inserted implants was lost, indicating a survival rate of 100%.