title: Piezoelectric alveolar ridge-splitting technique with simultaneous implant placement: a cohort study with 2-year radiographic results.
abstract: OBJECTIVE
  Extended grafting procedures in atrophic ridges are invasive and time-consuming and increase cost and patient morbidity. Therefore, ridge-splitting techniques have been suggested to enlarge alveolar crests. The aim of this cohort study was to report techniques and radiographic outcomes of implants placed simultaneously with a piezoelectric alveolar ridge-splitting technique (RST). Peri-implant bone-level changes (ΔIBL) of implants placed with (study group, SG) or without RST (control group, CG) were compared.
  
  
  METHODS
  Two cohorts (seven patients in each) were matched regarding implant type, position, and number; superstructure type; age; and gender and received 17 implants each. Crestal implant bone level (IBL) was measured at surgery (T0), loading (T1), and 1 year (T2) and 2 years after loading (T3). For all implants, ΔIBL values were determined from radiographs. Differences in ΔIBL between SG and CG were analyzed statistically (Mann-Whitney U test). Bone width was assessed intraoperatively, and vertical bone mapping was performed at T0, T1, and T3.
  
  
  RESULTS
  After a mean observation period of 27.4 months after surgery, the implant survival rate was 100%. Mean ΔIBL was -1.68 ± 0.90 mm for SG and -1.04 ± 0.78 mm for CG (P = .022). Increased ΔIBL in SG versus CG occurred mainly until T2. Between T2 and T3, ΔIBL was limited (-0.11 ± 1.20 mm for SG and -0.05 ± 0.16 mm for CG; P = .546). Median bone width increased intraoperatively by 4.7 mm.
  
  
  CONCLUSIONS
  Within the limitations of this study, it can be suggested that RST is a well-functioning one-stage alternative to extended grafting procedures if the ridge shows adequate height. ΔIBL values indicated that implants with RST may fulfill accepted implant success criteria. However, during healing and the first year of loading, increased IBL alterations must be anticipated.
authors.forename: Renzo
authors.initials: R
authors.lastname: Bassetti
authors.forename: Mario
authors.initials: M
authors.lastname: Bassetti
authors.forename: Regina
authors.initials: R
authors.lastname: Mericske-Stern
authors.forename: Norbert
authors.initials: N
authors.lastname: Enkling
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D015331:Cohort Studies; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D059745:Piezosurgery / Q000379:methods*; D011859:Radiography; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
chemical_list: D015921:Dental Implants