Ridge Splitting Technique Research Articles

Efficacy of Regenerative Materials and Ultrasonic Ridge Splitting Technique with Simultaneous Implants Placement into Narrow Alveolar Ridge

Aim: This study compares clinically and radiographically between efficacies of two different bone graft materials with amniotic membrane in narrow alveolar ridges subjected to ridge expansion by ultrasonic bone surgery to receive simultaneous implant placement. Subjects and Methods: Twenty-two systemically healthy patients with partial edentulous narrow anterior maxillary ridge classified randomly into the following equal groups: Group Ι patients with partial edentulous narrow ridge; treated by ridge splitting technique and simultaneous implant placement into their ridge; associated with deproteinized bovine bone (Bio-Oss ®) and amniotic membrane. Group II patients with partial edentulous narrow ridge; treated by ridge splitting technique and simultaneous implant placement into their ridge; associated with hydroxyapatite and 40% beta-tricalcium phosphate (easy-graft™ crystal) and amniotic membrane. Evaluation of implant success rate was done, and the clinical parameters were recorded for all implants. Implant stability quotient (ISQ) values was recorded. Efficacy of regenerative materials was observed by evaluation of marginal bone level and bone density. Results: Alveolar ridge width was increased in all groups. The mean value of alveolar ridge width in group I 3.64 mm ±0.3 at baseline that increased to 6.90mm ±0.6. The mean value of Alveolar ridge width in group II was 4.17 mm ±0.7at baseline that increased to 6.65 mm ±0.4. Group II showed the highest ISQ, bone density and the lowest marginal bone loss values after twelve months of implant placement. Conclusion: The use of piezo-electric surgery with bone grafting as sole tool for ridge splitting is promising technique.

The Effect of Piezosurgical Ridge Splitting and Osseodensification on The Primary Stability of The Implant in Narrow Ridge: (Comparative Randomized Controlled Split Mouth Clinical Trial)

Aim: This study aims to evaluate the effect of and compare between the piezosurgical ridge splitting and osseodensification in implant primary stability. Subjects and Methods: 28 implants were divided into two groups. Group I: 14 implants in sites received piezosurgery technique. Group II: 14 implants in sites received osseodensification technique. Then, all implants were evaluated clinically for primary stability after implant insertion by Osstell mentor magnetic resonance device and radiographically for peri-implant bone density. Results: unpaired t-test between the two groups showed moderate statistical significant difference in group II when compared with group I in both primary stability and bone density Conclusion: The primary stability in both piezosurgical ridge splitting and osseodensification techniques is within normal range but in favor of osseodensification technique suggesting that osseodensification enhance the bone density thereby improve the implant primary stability.

Hard and Soft Peri-Implant Tissue Augmentation using Ridge Split with Guided Bone Regeneration and Free Gingival Autograft.

Horizontal ridge deficiency, particularly in the mandibular arch, poses a challenge for implant supported rehabilitation. Ridge split, along with expansion, allows simultaneous implant placements in such defects, and avoids the delay which usually follows hard tissue augmentation procedures. A 53 year old female with missing mandibular anterior teeth and a bucco-lingual ridge deficiency was treated using the ridge split technique and simultaneous implant placement. Demineralized freeze dried bone allograft (DFDBA) along with anorganic bovine bone (ABB) was packed in the expanded crypt and covered by a collagen membrane. Following successful implant osseointegration, soft tissue augmentation by a vestibular deepening procedure with a strip of autogenous free gingival graft was performed. Prosthetic rehabilitation was done using a cement retained prosthesis after the healing phase. The case was then followed up for 3 years where stable results were noted. Condensed treatment time and a predictable outcome was achieved by using this technique.

Management of the Athrofic Maxilar Crest with the Ridge Split Technique

Introduction: the bony atrophy of the maxillary ridge is always a limitation to install dental implants. The Ridge Split procedure proves to be a successful technique to perform the management of horizontal defects, increasing the dimensions of the atrophic ridge to immediately install dental implants. Aim: to describe the clinical use of the Ridge Split technique as a treatment for bone augmentation in the horizontal direction of the atrophic maxilla. Case presentation: the case of a female patient of 61 years of age, partially edentulous, who seeks to recover her upper teeth was presented. The clinical examination shows only two teeth and the radiographic-tomographic examination showed severe bone resorption and pneumatization of the maxillary sinuses. It is planned to install two implants to make an over denture, using the Ridge Split technique and immediate installation of the implants. Five months later, a tomographic control was performed evidencing a horizontal increase of the alveolar ridge and it was rehabilitated with an overdenture, with which the patient's aesthetic and functional compliance was achieved. Conclusion: the presented case reveals that this technique increases the bone ridge in horizontal direction and allows to install the implants simultaneously. It is a predictable, safe and comfortable treatment, and shortens the treatment time, making it a viable alternative for the management of alveolar bone defects.

Implant placement with Bio-Oss mixed platelet rich fibrin after ridge splitting in lower anterior area

Objective: to evaluate clinically and radiographically implant placement with Bio-Oss mixed with platelet rich fibrin after ridge splitting in lower anterior area. Methods: This study included 10 male patients suffering from loss of lower anterior teeth with bone loss leaving 7-8 mm of bone height and need implant to restore function in anterior region. The patients divided into two groups: In group (I) the patients treated with dental implant placement with Bio-Oss mixed platelet rich fibrin after ridge splitting in lower anterior mandible. In group (II) the patients treated with dental implant placement without the use of any graft material after ridge splitting in lower anterior mandible. Clinical examination was made to edentulous regions: Quality, quantity of the mucosa, contour of the underlying bone and crown to bone relationship. Preoperative Cone Beam Computed Tomography (CBCT) was taken for patient to determine alveolar bone height and width. The Bio-Oss graft mixed with PRF was packed carefully around implant and between buccal and lingual plate. Follow up was made to detect changes in bone density, ridge width and implant stability. All readings were recorded and analyses statistically. Results: the study showed a statistical improvement in ridge width, bone density and implant stability. Conclusion: PRF mixed with Bio-Oss provides a stable widening of the alveolar ridge, prevent soft tissue migration to gap around implant and prevent collapsed buccolingual plate of bone after ridge splitting technique.

Effect of Osteon II Collagen with Hyaluronic Acid on Osseointegration of simultaneous placed implant in piezoelectric splitted posterior mandibular alveolar ridge (Clinical and radiographic study)

Aim: The present study was designed to estimate clinically and radiographically effect of Osteon II Collagen with Hyaluronic Acid on osseointegration of simultaneous placed implant in posterior mandibular alveolar ridge after piezoelectric ridge splitting technique (RST) .Patients & methods: This study was carried out on twenty one patients with partial edentulous narrow posterior mandibular alveolar ridge. Patients were divided randomly into three equal groups (group I treated by piezoelectric RST and simultaneous implant placement into their ridge; without any bone graft, group II treated by piezoelectric RST and simultaneous implant placement into their ridge which was grafted by Osteon II Collagen, while group III treated by piezoelectric RST and simultaneous implant placement into their ridge; associated with placement of Osteon II Collagen when mixed with Hyaluronic Acid in splitted alveolar ridge. Alveolar ridge in all group covered by guided tissue regeneration membrane after implant placement and bone grafting. Patients were evaluated clinically to assess probing depth (PPD), and implant stability quotient (ISQ) then radiographically to assess alveolar ridge width, marginal bone level (MBL), and bone density measurement (BD) parameters at 3, 6, 9 &12 months. Results: Statistical analysis of PPD and ISQ results showed no significant difference between groups at the different intervals while MBL values showed that there is high statistical significant difference during 12 month interval when comparing group III vs. group II. On the same side, BD results showed that group III had highly statistical significant difference at all intervals when it was compared with group I. and at 6, 9 and 12 months when comparing G III vs. G II. Conclusion: The present study concluded that Osteon II Collagen with Hyaluronic Acid may be adjunctive tool to accelerate bone osseointegration around immediate placed dental implant in posterior mandibular alveolar ridge after piezoelectric ridge splitting technique.

Alveolar Ridge Split Technique with Immediate Implant Placement: a Case Report

Alveolar Ridge Split Technique with Immediate Implant Placement: a Case Report

Grafted versus non grafted ultrasonic ridge splitting technique with simultaneous implants placement into narrow posterior mandibular alveolar ridge: a clinical and radiographic study

The present study was designed to compare clinically and radiographically between the traditional methods and the ultrasound in ridge splitting technique (RST) with simultaneous implant placement into narrow posterior mandibular alveolar ridge. This study was carried out on 20 patients with partial edentulous narrow posterior mandibular alveolar ridge. Patients were divided randomly into two equal groups (group I was treated with RST with osteotome and simultaneous implant placement into their ridges associated with bone graft as a gap filler after splitting; group II was treated with RST by the ultrasound and simultaneous implant placement into their ridges associated with bone graft as a gap filler after splitting). Patients were evaluated clinically to assess probing depth and implant stability quotient, and radiographically to assess the alveolar ridge width and the marginal bone level measurement parameters at 3, 6, 9, and 12 months. The results of the present study showed no significant difference of postpartum depression and significant difference in implant stability quotient between the two groups at the second interval, and there was a superiority of the group ll in marginal bone level between the two groups at the different intervals with statistically significant difference, especially at the end of the observation. Keywords: Implant, osteotome, ultrasonic ridge splitting technique.

Effect of ultrasonic ridge splitting technique with simultaneous implants placement into narrow posterior mandibular alveolar ridge: a clinical and radiographic study

Effect of ultrasonic ridge splitting technique with simultaneous implants placement into narrow posterior mandibular alveolar ridge: a clinical and radiographic study

Finite Element Analysis and Biomechanical Testing to Analyze Fracture Displacement of Alveolar Ridge Splitting

The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an unpredictable risk of fracturing the buccal lamella during the expansion. Currently, there is no preoperative assessment to predict the maximum distraction of the lamella. The aim of this study was to develop a biomechanical model to mimic the alveolar ridge splitting and a finite element (FE) model to predict the experimental results. The biomechanical testing was conducted on porcine mandibles. To build the FE model high resolution peripheral quantitative computer tomography scans of one specimen was performed after the osteotomy outline, but before the lamella displacement. A servo-electric testing machine was used for the axial tension test to split the lamellae. Results showed, in line with clinical observations, that the lamellae broke primarily at the base of the splits with a median displacement of 1.27 mm. The FE model could predict fracture force and fracture displacement. Fracture force showed a nonlinear correlation with the height of the bone lamella. In conclusion, good correspondence between mechanical testing and virtual FE analysis showed a clinically relevant approach that may help to predict maximum lamella displacement to prevent fractures in the future.

PC328: A novel staged ridge splitting technique with lateral windows for implant placement in the severely resorbed mandible: a case report

PC328: A novel staged ridge splitting technique with lateral windows for implant placement in the severely resorbed mandible: a case report

Ridge splitting technique: a case series comparing of two different flap approaches

Ridge splitting technique: a case series comparing of two different flap approaches

The placement of dental implants in the atrophic jaws with ridge split technique and horizontal distraction osteogenesis. Literature review

The placement of dental implants in the atrophic jaws with ridge split technique and horizontal distraction osteogenesis. Literature review

Leukocyte platelet-rich fibrin versus platelet-rich fibrin block in ridge splitting technique with simultaneous implant placement

Leukocyte platelet-rich fibrin versus platelet-rich fibrin block in ridge splitting technique with simultaneous implant placement

MUCOSAL FLAP VERSUS MUCOPERIOSTEAL FLAP IN RIDGE SPLITTING AND SIMULTANEOUS IMPLANT PLACEMENT USING PIEZOSURGERY (A RANDOMIZED CONTROLLED CLINICAL TRIAL)

INTRODUCTION: Ridge split procedures are commonly performed for horizontal widening-augmentation of narrow ridges which would otherwise preclude implant placement. Post-surgical vertical and horizontal crestal bone loss that might occur secondary to ridge splitting techniques present a serious obstacle to the success of implant placement and prognosis. OBJECTIVES: The evaluation of the effectiveness of maintaining the periosteal attachment of the buccal and lingual cortical plates to reduce and/or prevent crestal bone loss that might occur at the crestal margin of dental implants placed immediately in posterior mandibular alveolar ridges splitted using piezosurgery. MATERIALS AND METHODS: That was a randomized controlled clinical trial. The study population included 16 patients with edentulous posterior mandibular alveolar ridges. The sample was selected conveniently to fulfill a list of inclusion and exclusion criteria. Then the selected participants were allocated randomly into two equal groups each including 8 patients. A full thickness mucoperiosteal flap were performed in the control group patients, while a split thickness mucosal flap was done in the study group patients. All patients had undergone a mandibular ridge splitting technique using piezoelectrical surgical device. After ridge-splitting-porcedure implants with interpositional grafts were placed immediately. Assessments included measurements of the linear changes in the marginal bone surrounding the implants immediately postoperative as baseline, 3, 6 and 9 months postoperative. RESULTS: The statistical analysis of measurements obtained from both groups showed no significant difference between control and study groups regarding pain and edema assessment, while probing depth, and marginal bone level showed significant difference between both groups in favor to the study group. CONCLUSIONS: The ridge splitting technique using a partial thickness flap could be a successful option for the reduction of marginal bone loss around immediately inserted implants

Lateral Ridge Splitting (Expansion) With Immediate Placement of Endosseous Dental Implant Using Piezoelectric Device: A New Treatment Protocol.

Many treatment modalities have been introduced for correction of deficient alveolar ridge width. Bone expansion through the ridge split procedure is one of them. This technique was initiated in order to overcome many problems that usually associated with grafting procedures. The present study evaluated the effectiveness of piezoelectric device in performing ridge split using single-stage approach and assessed the outcomes during a period of about 4 months after surgery. A total of 23 patients aged in range between 18 and 60 years underwent ridge split procedure with immediate insertion of dental implants. A panoramic radiograph was obtained before surgery. The gained bone was measured and surgical complications were recorded. Implants stability was measured using Osstell device. Postoperative clinical complications were assessed. After a healing period of 16 weeks, all the implants were uncovered and evaluated regarding clinical, radiographic, and resonance frequency analysis findings. The totally implemented ridge split procedures were 26 cases including 57 implants inserted immediately at the time of surgery. The initial ridge width varied between 1 and 3.5 mm while the final width ranged from 5.5 to 8 mm. The minimum bone gain was 2.5 mm and the maximum value reached up to 7 mm. Few and insignificant clinical complications were recorded during the whole study. The survival rate was 100%. The study results indicated that piezoelectric ridge splitting technique is an effective, safe, and minimally invasive procedure. This technique has showed to be very successful in reducing the overall treatment period.

Alveolar Ridge Split Technique Using Piezosurgery with Specially Designed Tips.

The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques introduced for the expansion of alveolar ridges with a horizontal bone deficit is the alveolar ridge split technique. The aim of this article is to give a description of some new tips that have been specifically designed for the treatment of atrophic ridges with transversal bone deficit. A two-step piezosurgical split technique is also described, based on specific osteotomies of the vestibular cortex and the use of a mandibular ramus graft as interpositional graft. A total of 15 patients were treated with the proposed new tips by our department. All the expanded areas were successful in providing an adequate width and height to insert implants according to the prosthetic plan and the proposed tips allowed obtaining the most from the alveolar ridge split technique and piezosurgery. These tips have made alveolar ridge split technique simple, safe, and effective for the treatment of horizontal and vertical bone defects. Furthermore the proposed piezosurgical split technique allows obtaining horizontal and vertical bone augmentation.

Implant Placement in a Compromised Region - Ridge Split Technique

Implant Placement in a Compromised Region - Ridge Split Technique

Biomechanical comparison of a novel engine‐driven ridge spreader and conventional ridge splitting techniques

Ridge splitting techniques are used for horizontal ridge augmentation in implant dentistry. Recently, a novel engine-driven ridge splitting technique was introduced. This study compared the mechanical forces produced by conventional and engine-driven ridge splitting techniques in porcine mandibles. In 33 pigs, mandibular premolar areas were selected for the ridge splitting procedures, designed as a randomized split-mouth study. The conventional group underwent a chisel-and-mallet procedure (control group, n=20), and percussive impulse (Newton second, Ns) was measured using a sensor attached to the mallet. In the engine-driven ridge spreader group (test group, n=23), a load cell was used to measure torque values (Newton centimeter, Ncm). Horizontal acceleration generated during procedures (control group, n=10 and test group, n=10) was compared between the groups. After ridge splitting, the alveolar crest width was significantly increased both in the control (1.23±0.45mm) and test (0.98±0.41mm) groups with no significant differences between the groups. The average impulse of the control group was 4.74 ± 1.05Ns. Torque generated by rotation in the test group was 9.07 ± 2.15Ncm. Horizontal acceleration was significantly less in the test group (0.82±1.05g) than the control group (64.07±42.62g) (P<0.001). Narrow edentulous ridges can be expanded by novel engine-driven ridge spreaders. Within the limits of this study, the results suggested that an engine-driven ridge splitting technique may be less traumatic and less invasive than a conventional ridge splitting technique.

Lateral Alveolar Ridge Expansion in the Anterior Maxilla Using Piezoelectric Surgery for Immediate Implant Placement.

The purpose of this study was to evaluate the efficacy of the ridge-splitting technique in the anterior maxilla, using piezoelectric surgery for immediate implant placement. Study outcomes were compared with those of implant placement in the same patients using the conventional drilling technique. Ten patients received a total of 22 implants in the anterior maxilla, 11 of which were placed using a ridge-splitting procedure (test group) and the other 11 using the conventional drilling procedure (control group). Ridge width (RW), crestal bone level (BL), and implant stability quotient (ISQ) were measured at different points in time. Data were analyzed and compared between the groups using analysis of variance (ANOVA) and paired-sample t tests at a significance level of 5%. For the test group, the gain in RW was not stable in time because at 6 months postoperatively, the RW lost some of the initial gain; however, the net gain was still significant. At 6 months postoperatively, BL was similar for both groups. The net bone loss on the mesial aspect and the average of the mesial and the distal measures did not differ significantly between both groups. ISQ values sharply increased at 3 months postoperatively in the test group. All implants met the modified Albrektsson criteria (1989) for success. The results from this study support the efficacy and safety of ridge expansion using piezoelectric surgery for implant insertion in the anterior maxilla. The modest net gain in bone width suggests that additional hard and soft tissue augmentation may be necessary, especially in the esthetic zone. ISQ values suggest a minimum healing time of 3 months before loading the implants that have been inserted using this ridge-splitting protocol.