This method consists of one stage.
The plate is removed in the same way as the previous method to access the bone directly. In this method the Perimucosal Extention element PME is placed just above the crest of bone.
Advantages:
Reaching the soft tissue simultaneously with the hard tissue
No need for a second stage of surgery
Flapless Procedure
In this method, the soft tissues of the crest modyle are not excluded, but instead, cylinders of keratinized tissue equivalent to the diameter of the crest modyle are removed from the crest, so no suturing is required. However, one of the main drawbacks of this method is the surgeon’s inability to estimate bone volume prior to osteotomy or during prosthodontic placement. So it seems clear that the surgeon is only allowed to use this procedure when the width of the bone is greater than 8 mm and the gums are sufficiently keratinized.