A Modified Ridge Splitting Technique Using Autogenous Bone Blocks—A Case Series

Abstract

Background: Alveolar atrophy following tooth loss is a common limitation of rehabilitation with dental implant born prostheses. Ridge splitting is a well-documented surgical method to restore the width of the alveolar ridge prior to implant placement. The aim of this case series is to present a novel approach to ridge expansion using only autogenous bone blocks. Methods: Patients with Kennedy Class I. and II. mandibles with insufficient bone width were included in this study. Ridge splitting was carried out with the use of a piezoelectric surgery device by preparing osteotomies and after mobilization of the buccal cortical by placing an autologous bone block harvested from the retromolar region as a spacer between the buccal and lingual cortical plates. Block-grafts were stabilized by osteosynthesis screws. Implant placement was carried out after a 3-month healing period. A total of 13 implants were placed in seven augmented sites of six patients. Results: Upon re-entry, all sites healed uneventfully. Mean ridge width gain was 2.86 mm, range: 2.0–5.0 mm. Conclusions: Clinical results of our study show that the modified ridge splitting technique is a safe and predictable method to restore width of the alveolar ridge prior to implant placement.

Evaluation of Bone Width Recovery After Using Modified Ridge Splitting Technique With and Without Beta-Tricalcium Phosphate Material (A randomized clinical trial)

“…However, it is preferable since it requires only one surgical site and does not require autogenous bone or membrane, making it a competitive and reliable procedure for horizontal bone augmentation (12) . This encouraging outcome is consistent with the findings of Altiparmak et al 2017, Atef et al 2019, and Pénzes et al 2020, who discovered that this procedure produced superior results when compared to onlay grafts and autougenous bone blocks, respectively (13,18,19) .…”

Evaluation of One-Stage Inverted U-Shaped Ridge Splitting and Concurrent Implant Placement in Anterior Maxillary Undercut Defect(a Clinical Trial)

“…Spontaneous ossification, similar to that seen in fractures and tooth extraction sites and new bone production, enables fusion of the alveolus's oral and buccal bone plates (16,17). Alveolar ridge splitting with a piezotome is a welldocumented procedure for restoring alveolar ridge thickness prior to implant insertion, in agreement with Pénzes et al (18) and is documented as preferrable alternative to autologous bone-blockgrafting (19). Studies showed that alveolar ridge splitting technique (ARST) fulfill all requirements for best bone healing/regeneration of bony defects, such as minimum bone loss, the preservation of bony walls, a closed healing environment, provision of space and mechanical wound stability (11,12,20).…”

Edentulous Space Closure Using a Clear Aligner System After Alveolar Ridge Split Augmentation

“…According to Simion and colleagues, 1 to 1.5 mm expansion of alveolar bone can be gained at a mandibular site and 3 to 4 mm at a maxillary site on average 4,6. In our case, mandibular alveolar bone expansion reached 3 mm.…”

“…The vertical cuts should be done 1 mm away from the adjacent teeth 7. Alveolar ridge splitting technique can be implemented either by chisels or mallets, scapells, spatulas, osteotomes, piezotomes, and extra fine tissue burs 1,4–6,8. The most widely used technique is the osteotomes because of the low cost and the acceptable quality of the surgery.…”

“…Major orthodontic implications include uncontrolled movements, root resorption, or/and periodontal problems. Several different techniques have been previously described to augment bone including distraction osteogenesis, autogenous block onlay grafts, guided bone regeneration combined with autografts or xenografts, shell technique, swinging interpositional grafts, and alveolar ridge splitting technique (ARST) 1–5. These techniques are most commonly used to create an adequate bone volume to place dental implants that will support a dental prosthesis.…”