Background
The lack of adequate bone thickness is a limitation for implant placement. Ridge splitting is a procedure to increase bone width. It can be done in one or two stages. In two-stage approach, after the separation of the bone plates, a graft is placed between them to help maintain the increase achieved. Although this is a predictable procedure, the biologic remodelling of the graft is needed in order to get new bone formation.
Aims
To evaluate a protocol for ridge splitting using a space maintainer, without a graft interposed.
Methods
Seven cases with reduced bone thickness, with indication for a two stage ridge splitting, were selected. After raising the flap, a longitudinal bone cut to the proper depth, according to the future implants, and two vertical cuts, at mesial and distal of the working area using piezoelectric surgery were performed. Subsequently, a side action expander was introduced in the longitudinal cut to separate the plates. This has a fixed part and a mobile one. The later is moved bucally by rotating a wheel. Once the separation was obtained, of about 3mm to avoid a possible fracture of the buccal plate, a 2.8 mm diameter screw was placed between the tables to act as a space maintainer, avoiding the use of a graft. Finally the area was covered with a collagen membrane and soft tissues were closed without tension. Re-entry was performed at 45 days. Surgical sockets were created using threaded expanders and the implants were placed.
Results
All cases showed new bone formation at the time of reentry. Bone width gain was between 5 and 7 mm, being the highest when complementary ridge splitting was carried out at the time of implant placement.
Conclusions
Within the limits of this study, the protocol used has proved to be effective in all cases. The side action expander was useful to obtain a controlled expansion of the plates. The use of a space maintainer in conjunction with a collagen membrane allowed a “de novo” bone formation, without having to wait for the remodeling of a graft, which speeds the treatment time and gives a better bone quality at the time of implant placement. A larger scale controlled study is needed to confirm the observations made.
Background
The lack of adequate bone thickness is a limitation for implant placement. Ridge splitting is a procedure to increase bone width. It can be done in one or two stages. In two-stage approach, after the separation of the bone plates, a graft is placed between them to help maintain the increase achieved. Although this is a predictable procedure, the biologic remodelling of the graft is needed in order to get new bone formation.
Aims
To evaluate a protocol for ridge splitting using a space maintainer, without a graft interposed.
Methods
Seven cases with reduced bone thickness, with indication for a two stage ridge splitting, were selected. After raising the flap, a longitudinal bone cut to the proper depth, according to the future implants, and two vertical cuts, at mesial and distal of the working area using piezoelectric surgery were performed. Subsequently, a side action expander was introduced in the longitudinal cut to separate the plates. This has a fixed part and a mobile one. The later is moved bucally by rotating a wheel. Once the separation was obtained, of about 3mm to avoid a possible fracture of the buccal plate, a 2.8 mm diameter screw was placed between the tables to act as a space maintainer, avoiding the use of a graft. Finally the area was covered with a collagen membrane and soft tissues were closed without tension. Re-entry was performed at 45 days. Surgical sockets were created using threaded expanders and the implants were placed.
Results
All cases showed new bone formation at the time of reentry. Bone width gain was between 5 and 7 mm, being the highest when complementary ridge splitting was carried out at the time of implant placement.
Conclusions
Within the limits of this study, the protocol used has proved to be effective in all cases. The side action expander was useful to obtain a controlled expansion of the plates. The use of a space maintainer in conjunction with a collagen membrane allowed a “de novo” bone formation, without having to wait for the remodeling of a graft, which speeds the treatment time and gives a better bone quality at the time of implant placement. A larger scale controlled study is needed to confirm the observations made.
Background
The lack of adequate bone thickness is a limitation for implant placement. Ridge splitting is a procedure to increase bone width. It can be done in one or two stages. In two-stage approach, after the separation of the bone plates, a graft is placed between them to help maintain the increase achieved. Although this is a predictable procedure, the biologic remodelling of the graft is needed in order to get new bone formation.
Aims
To evaluate a protocol for ridge splitting using a space maintainer, without a graft interposed.
Methods
Seven cases with reduced bone thickness, with indication for a two stage ridge splitting, were selected. After raising the flap, a longitudinal bone cut to the proper depth, according to the future implants, and two vertical cuts, at mesial and distal of the working area using piezoelectric surgery were performed. Subsequently, a side action expander was introduced in the longitudinal cut to separate the plates. This has a fixed part and a mobile one. The later is moved bucally by rotating a wheel. Once the separation was obtained, of about 3mm to avoid a possible fracture of the buccal plate, a 2.8 mm diameter screw was placed between the tables to act as a space maintainer, avoiding the use of a graft. Finally the area was covered with a collagen membrane and soft tissues were closed without tension. Re-entry was performed at 45 days. Surgical sockets were created using threaded expanders and the implants were placed.
Results
All cases showed new bone formation at the time of reentry. Bone width gain was between 5 and 7 mm, being the highest when complementary ridge splitting was carried out at the time of implant placement.
Conclusions
Within the limits of this study, the protocol used has proved to be effective in all cases. The side action expander was useful to obtain a controlled expansion of the plates. The use of a space maintainer in conjunction with a collagen membrane allowed a “de novo” bone formation, without having to wait for the remodeling of a graft, which speeds the treatment time and gives a better bone quality at the time of implant placement. A larger scale controlled study is needed to confirm the observations made.
Background
The lack of adequate bone thickness is a limitation for implant placement. Ridge splitting is a procedure to increase bone width. It can be done in one or two stages. In two-stage approach, after the separation of the bone plates, a graft is placed between them to help maintain the increase achieved. Although this is a predictable procedure, the biologic remodelling of the graft is needed in order to get new bone formation.
Aims
To evaluate a protocol for ridge splitting using a space maintainer, without a graft interposed.
Methods
Seven cases with reduced bone thickness, with indication for a two stage ridge splitting, were selected. After raising the flap, a longitudinal bone cut to the proper depth, according to the future implants, and two vertical cuts, at mesial and distal of the working area using piezoelectric surgery were performed. Subsequently, a side action expander was introduced in the longitudinal cut to separate the plates. This has a fixed part and a mobile one. The later is moved bucally by rotating a wheel. Once the separation was obtained, of about 3mm to avoid a possible fracture of the buccal plate, a 2.8 mm diameter screw was placed between the tables to act as a space maintainer, avoiding the use of a graft. Finally the area was covered with a collagen membrane and soft tissues were closed without tension. Re-entry was performed at 45 days. Surgical sockets were created using threaded expanders and the implants were placed.
Results
All cases showed new bone formation at the time of reentry. Bone width gain was between 5 and 7 mm, being the highest when complementary ridge splitting was carried out at the time of implant placement.
Conclusions
Within the limits of this study, the protocol used has proved to be effective in all cases. The side action expander was useful to obtain a controlled expansion of the plates. The use of a space maintainer in conjunction with a collagen membrane allowed a “de novo” bone formation, without having to wait for the remodeling of a graft, which speeds the treatment time and gives a better bone quality at the time of implant placement. A larger scale controlled study is needed to confirm the observations made.