Mandibular Ridge Splitting and Gradual Bone Expansion Technique for Immediate Placement of Implant in the Posterior Thin Region: A Clinical Report

Massoumeh Khoshhal,Parviz Torkzaban,Shilan Razaghi,Fariborz Vafaee

doi:10.17795/ajdr-19463

Abstract

Introduction: Narrow alveolar ridges especially in posterior mandibular remains a serious challenge for successful placement of endosseous implants. Case Presentation: This case report addresses surgical procedures for widening the atrophic ridge by means of splitting the crest of an edentulous ridge as thin as 2.5 mm and gradual expansion in the posterior mandibular ridge, then simultaneous placement of dental implants within the split ridge. A significant increase was achieved in the bone dimension, which enabled the placement of endosseous dental implants successfully. Discussion: This segmental ridge-split procedure with gradual bone expansion provides a quicker method wherein an atrophic ridge can be predictably expanded and eliminating the need for a second surgical site. This technique also shows that immediate implantation in split ridge of mandible can be performed.

Highlights

Narrow alveolar ridges especially in posterior mandibular remains a serious challenge for successful placement of endosseous implants
Treatment of atrophic ridge especially in posterior mandibular is accompanied with great problem in achieving successful results with endosseous implants
A significant increase was achieved in the bone dimension, which enabled the placement of endosseous dental implants successfully

Summary

Introduction

Patients are more interested in dental treatments with better esthetic results and less treatment time. The buccal cortex is positioned laterally to create space between buccal and lingual cortical plates, which is filled by endosseous implant with or without any graft material [15, 16] This technique is performed with immediate implant placement, which decreases the treatment time significantly. Other advantages include lesser overall cost, no need of barrier membranes or bone graft materials and no morbidity related to second donor site This technique is more suitable for maxilla and can be performed in posterior mandibular region if favorable condition exists [15]. A staged approach to ridge splitting in the mandible can be performed to avoid complications Another technique for placement of dental implants in narrow bone ridges is repositioning and remodeling of alveolar bone by controlled expansion. This clinical report describes the technique for ridge splitting, gradual expansion in the mandible and simultaneous implant placement within the split ridge

Case Presentation

Discussion