Alternative bone expansion technique for immediate placement of implants in the edentulous posterior mandibular ridge: a clinical report.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of a split-crest bone augmentation technique performed for immediate implant placement in thin edentulous posterior mandibular ridges.


METHODS
In the present study, 125 implants were placed in posterior mandibular ridges of 30 patients. The mandibular buccal walls were split, expanded, and grafted with a combination of platelet-rich plasma and Cerasorb. The split segments were held in place by cortical bone screws. Before loading, periodontal status was checked, implant stability was evaluated with the Periotest, and panoramic radiographs and computerized tomography scans were obtained. Second-stage surgery (cover screw removal and healing abutment placement) was performed after 3 to 4 months.


RESULTS
All implants osseointegrated successfully and underwent loading after 4 months. Optimal healing occurred 3 to 4 months earlier than the usual 6 to 9 months required, and no lip paresthesia was noted.


CONCLUSIONS
Although onlay-inlay grafts, sandwich osteotomies, guided bone regeneration, piezoelectricity, and alveolar distraction have been indicated for augmentation in the posterior mandibular region, each of these techniques involves risks and complications. The crest-splitting bone expansion technique enables single-stage immediate implant placement and lateral ridge augmentation in thin crests and may prevent neurosensorial deficiencies.


CONCLUSIONS
The split-crest surgical technique is a valid reconstructive procedure for sharp posterior mandibular ridges. If performed using platelet-rich plasma and Cerasorb, it can shorten the osseointegration period.
Basa
Selcuk
S
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey. basas@turk.net
Varol
Altan
A
Turker
Neslihan
N
D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001792:Blood Platelets; D001863:Bone Screws; D018786:Bone Substitutes; D002130:Calcium Phosphates; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration; D010983:Plateletpheresis; D013997:Time Factors
D018786:Bone Substitutes; D002130:Calcium Phosphates; D015921:Dental Implants; C485817:beta-tricalcium phosphate