Journal of Oral Implantology February 2013 - (Page 59)

CLINICAL Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical Modality in Implant Reconstruction Len Tolstunov, DDS, DMD1* Bruce Hicke, DDS2 Among alveolar ridge augmentation techniques, the ridge-split procedure demonstrates many benefits, including no need for a second (donor) surgical site, rare risk of inferior alveolar nerve injury, and less pain and swelling, and others. Lateral bone augmentation through the ridge-split works best in a localized lateral bony defect intended for 1 or 2 implants and where the ridge is vertically intact. In this article, the authors present a detailed description of the implant-driven technique of alveolar ridge-split procedure in small and large bone deficiencies, in maxilla and mandible, supplemented by multiple photographs. The authors emphasize the need for careful manipulation of the thin ridge based on knowledge of precise surgical principles and stress that a practitioner needs specialized training and experience to perform this type of alveolar bone augmentation. Key Words: split-crest, bone expansion, ridge manipulation INTRODUCTION S ince the introduction of root-form endosseous dental implants, the need to establish a proper alveolar ridge has become essential. Two-dimensional hard-tissue augmentation techniques are mainly designed for vertically preserved but width-deficient alveolar ridges, and 3-dimensional (3D) hard-tissue grafting procedures are intended to gain height and width in volumetrically deficient ridges. Many surgical pre-implant bone augmentation techniques have the goal of reconstructing deficient alveolar width, height, or both, including guided bone regeneration (GBR) with a cancellous graft, onlay/veneer block graft, inlay grafting, ridge split, and vertical and horizontal 1 Private practice, San Francisco, Calif, and Department of Oral and Maxillofacial Surgery, University of the Pacific, Arthur A. Dugoni School of Dentistry and University of California San Francisco, School of Dentistry, San Francisco, Calif. 2 Private practice, Rancho Cucamonga, Calif. * Corresponding author, e-mail: tolstunov@yahoo.com DOI: 10.1563/AAID-JOI-D-12-00112 distraction osteogenesis.1 Although ridge-widening techniques were used in the pre-implant era as a form of pre-prosthetic ridge plasty for the improved support of partial and full dentures, there has been renewed interest in such techniques in the past 30 years since the advent of osseointegration and root-form dental implants. An edentulous ridge expansion or split-crest technique for implant placement was originally described by Simion et al2 and later by Scipioni et al. 3 A few literature reports depict different modifications of a ridge-split procedure (RSP) with or without interpositional bone grafting in the edentulous maxilla4–13 and edentulous mandible.8,14–17 Following is a description of the classic RSP that has been successfully used for many years in the authors’ oral and maxillofacial surgery practices. In this article, the authors describe the RSP as a form of ridge modification (widening or augmentation), a technique that offers many advantages in oral pre-prosthetic implant reconstruction. Journal of Oral Implantology 59

Table of Contents for the Digital Edition of Journal of Oral Implantology February 2013

Could the Fountain of Youth Be All in Your Bones?
Vertical Bone Augmentation With Simultaneous Implant Placement Using Particulate
Evaluation of the Bone Healing Process Utilizing Platelet-Rich Plasma Activated by Thrombin
Effect of Model Parameters on Finite Element Analysis of Micromotions in Implant Dentistry
Peri-Implant Defect Augmentation With Autogenous Bone: A Study in Beagle Dogs
Would Nitric Oxide be an Effective Marker for Earlier Stages of Peri-Implant Disease? An
The Effect of Different Surface Treatments on Cement-Retained Implant-Supported
Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation
Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical
The Bis-Acryl Stent
Clinical, Histological, and Histomorphometrical Analysis of Maxillary Sinus Augmentation
A Technique to Salvage a Single Implant-Supported Fixed Dental Prosthesis Having a
Ridge Expansion and Immediate Placement With Piezosurgery and Screw Expanders in
Pterygoid Implants for Maxillofacial Rehabilitation of a Patient With a Bilateral Maxillectomy
Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management
Fracture of Anterior Iliac Crest Following Bone Graft Harvest in an Anorexic Patient: Case
A Technique for Constructing a New Maxillary Overdenture to a Nonretrievable Implant
Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of

Journal of Oral Implantology February 2013