A MODIFIED APPROACH FOR SPLIT CREST TECHNIQUE AND BONE EXPANSION TO AUGMENT NARROW ALVEOLAR RIDGES FOR PLACEMENT OF ENDOSSEOUS IMPLANTS

The application of a revisited split crest technique on a case series of 10 patients.

Summary: Insufficient width of the alveolar ridge often prevents ideal implant placement. Guided bone regeneration, bone grafting, alveolar ridge splitting and combinations of these techniques are used for the lateral augmentation of the alveolar ridge. Ridge splitting is a minimally invasive technique indicated for alveolar ridges with adequate height, which enables immediate implant placement and eliminates morbidity and overall treatment time. The classical approach of the technique involves splitting the alveolar ridge into 2 parts with use of osteotomes and chisels. Modifications of this technique include the use of rotating instrument, screw spreaders, horizontal spreaders and ultrasonic device.
Aims & Objectives: This study was carried out to determine (a) to measure the alveolar ridge height before and after implant placement and check the bone loss or gain after implant placement, (b) to favorably position the implant into the bone simulating the natural tooth position that is required for optimal restoration, (c) to prevent formation of unfavorable bucco-lingual /buccopalatal and mesio-distal discrepancy between implant and prosthesis and thus improve esthetics. Patients’ response to rehabilitation was monitored clinically & radiographically.
Materials & Method: Among 10 patients, with the average age of 35 yrs were treated for single tooth replacement in esthetic zone by placement of implants. In this study explained a technique of modified ridge split bone expansion osteotomy with simultaneous implant placement in esthetic zone. The alternate use of osteotomes and chisels relieve the stresses at the crest by extending a chisel cuts slight mesial and distal to osteotomy. Unlike segmental ridge splitting, no attempts are made to give vertical osteotomies cuts. The osseous defect was filled up with an equine based bone graft substitute Collagen granules Bio-Gen (Bioteck®, Italy) and covered with a restorable pericardial derived equine based Biocollagen GTR membrane (Bioteck® Italy) after the implant of suitable dimension is placed. The entire Patients’ were followed response to rehabilitation clinically & radiographically for one year after loading of implant.
Results: Follow up was done after surgery and placement of implant for marginal bone loss and Osseo integration after one year of implant placement with CBCT scan.

PRODUCTS USED: Bio-Gen Granules Biocollagen membrane

International Journal of Medical and Health Research