Journal of Oral Implantology August 2014 - (Page 479)

CASE REPORT Staged Ridge Splitting Technique for Horizontal Expansion in Mandible: A Case Report Mohit Kheur, MDS1 Sneha Gokhale, MDS2* Shivaswamy Sumanth, MDS2 Shantanu Jambekar, BDS1 Ridge split procedures are commonly performed for horizontal augmentation of narrow ridges which would otherwise preclude implant placement. A 47-year-old patient with bilaterally edentulous posterior mandibular ridges was treated in the Department of Periodontology and Implantology, M.A. Rangoonwala College of Dental Sciences and Research Centre, employing a ''staged ridge split'' technique. In this technique, a simple corticotomy at the crestal, apical, and lateral aspects of the buccal cortical plate of the mandible was performed. Following this, a month later, the ridge was expanded and bone graft OssiFi containing biphasic beta-tricalcium phosphate and hydroxyappatite was placed to maintain the gap between the cortices. Thereafter, implants were placed 3 months later. A successful prosthetic rehabilitation was done following a healing phase of 3 months. This approach leads to restoration of function with a predictable outcome and minimal risk of cortical plate fracture during the ridge expansion process. Key Words: implants, ridge split, ultrasound bone surgery INTRODUCTION D ental implants provide a novel method of successful and predictable treatment of partial or complete edentulism. The resorption of alveolar bone is a common sequel of tooth loss and presents a clinical problem for implant placement. Implants must be placed with at least 1 mm of bone on the buccal and lingual aspects in order to maintain crestal bone levels.1 Narrow edentulous ridges less than 5 mm wide present a challenge to the clinician for implant placement. Hence, lateral bone augmentation procedures are necessary. These procedures involve the use of bone grafting with different types of 1 Department of Prosthodontics and Oral & Maxillofacial Prosthesis, M.A. Rangoonwala College of Dental Sciences and Research Centre, Maharashtra, India. 2 Department of Periodontology and Implantology, M.A. Rangoonwala College of Dental Sciences and Research Centre, Maharashtra, India. * Corresponding author, e-mail: drsnehagaikwad@gmail.com DOI: 10.1563/AAID-JOI-D-12-00068 grafts (autografts, allografts, xenografts, or bone substitutes), guided bone regeneration (GBR) alone or in combination with grafting procedures,2,3 as well as the use of ridge expansion techniques utilizing split ridge osteotomy4 and horizontal distraction osteogenesis.5 The ridge split technique consists of splitting the vestibular and buccal cortical tables6 and further opening the space with osteotomes.7 Splitting is classically performed with chisel and hammer8 or with rotating9 or oscillating saws.10 Use of a bone chisel is traumatizing and stressful to the patient. Rotating and oscillating instruments increase the risk of damaging the gingiva, the lips, or the tongue. Ultrasonic bone surgery (USBS) represents a novel alternative technique for bone surgery.11 Ultrasonically moved knives have the ability to cut hard tissues, such as teeth and bone. In contrast, soft tissues such as gingiva, blood vessels, nerves, and sinus membranes are preserved from injury because they vibrate with the knife tip. In the mandible, there is a higher risk of bone fracture, as Journal of Oral Implantology 479

Table of Contents for the Digital Edition of Journal of Oral Implantology August 2014

Helping, Rather Than Criticizing, a Colleague May Lead to a Lifetime of Referrals
Utilization of Ethyl Cyanoacrylate and 2-Octyl Cyanoacrylate Adhesives for Autogenous Bone Graft Fixation: Histomorphometric Study in Rats
Conventional Versus Implant-Retained Overlay Dentures: A Pilot Study of Masseter and Anterior Temporalis Electromyography
Axial Relationship Between Dental Implants and Teeth/Implants: A Radiographic Study
The Effect of Dynamic Loading on Bacterial Colonization of the Dental Implant Fixture–Abutment Interface: An In Vitro Study
Longitudinal Implant Stability Measurements Based on Resonance Frequency Analysis After Placement in Healed or Regenerated Bone
A Clinical Report on the Use of Closed-Tray, Hex-Lock-Friction-Fit Implant Impression Copings
Immediate Restoration of NobelActive Implants Placed Into Fresh Extraction Sites in the Anterior Maxilla
Clinical Study of Flap Design to Increase the Keratinized Gingiva Around Implants: 4-Year Follow-Up
Use of Subepithelial Connective Tissue Graft as a Biological Barrier: A Human Clinical and Histologic Case Report
Calvarial Autogenous Bone Graft for Maxillary Ridge and Sinus Reconstruction for Rehabilitation With Dental Implants
Staged Ridge Splitting Technique for Horizontal Expansion in Mandible: A Case Report
An Overview of Zirconia Dental Implants: Basic Properties and Clinical Application of Three Cases
Dental Gypsum Verification Jig to Verify Implant Positions: A Clinical Report
Platelet-Rich Preparations to Improve Healing. Part I: Workable Options for Every Size Practice
Platelet-Rich Preparations to Improve Healing. Part II: Platelet Activation and Enrichment, Leukocyte Inclusion, and Other Selection Criteria

Journal of Oral Implantology August 2014