Maxillary alveolar bone ridge width augmentation using the frame-shaped corticotomy expansion technique

Abstract

Maxillary alveolar ridge expansion performed by intercortical bone splitting is a seducing alternative surgical procedure for alveolar bone widening. The aim of this technique is to gain enough bone width to be able to place a dental implant simultaneously. This technique avoids a second surgical site for bone graft harvesting. However there are risks of surgical failure caused by unintended bone fracture during expansion and implant placement, or by insufficient bone widening for implant insertion. To limit these risks, we have published expansion techniques using various corticotomies. These corticotomies are achieved according to bone anatomy, most of them remote from implant position. Bone fractures are guided during the bone expansion and the implant placement, avoiding cortical bursting. Wider and safer bone movements can be achieved allowing to place the forecasted implant with adequate dimensions, axis, and cervical position on the bone ridge. Our technique increases the success rate of both the bone volume expansion and the dental implant placement, and improve the functional and aesthetic result of implant and prosthesis restoration. Four main types of bone expansion movement using corticotomies have been described: expansion with apical cortical hinge, cortical translation, bi-cortical osteotomy, and frame-shaped corticotomy. Our subject is the alveolar bone width augmentation with the frame- shaped corticotomy expansion technique, which allows to place an implant in a narrow and concave alveolar bone, with a straightened axis, without modifying its cervical position on the bone ridge arch. A series of 10cases with a 1 to 5year surgical follow-up is studied. Implants were all placed in the same stage and their supported prosthesis successfully made. Peculiarities and interest of this technique are discussed.