Lateral Bone Condensing and Expansion for Placement of Endosseous Dental Implants: A New Technique
Placement of endosseous dental implants can be a problem due to bone resorption if the patient has been missing teeth for a considerable period of time. In the literature, bone-grafting techniques have shown variable results. Additionally, bone grafting requires a longer treatment time and a need for a second surgery, and it adds significant cost to the treatment. These factors often discourage patients from having dental-implant treatment. Another technique for placement of dental implants in narrow bone ridges is repositioning and remodeling of alveolar bone by condensing and expansion with the help of bone osteotomes. This article presents 2 cases, 1 in the maxilla and 1 in the mandible, for placement of endosseous dental implants with the use of a new bone-expansion osteotome kit that utilizes a screw-type configuration for bone condensing and expansion.Abstract
(A) The Meisinger Split Control Lateral Bone Expansion Kit. (B) Threadformer used for lateral bone expansion. (C) The 6 threadformers from left to right (2.7 mm–4.0 mm in diameter).
(A) Buccal bone loss secondary to tooth loss several years ago. (B) Threadformer being used in the pilot hole for lateral bone expansion. (C) A healing cap in place secondary to uncovery (6 weeks after implant surgery). (D) Final implant-supported crown in place. Significant buccal bone remodeling is evident.
(A) Preoperative photograph showing thin bone in the area missing mandibular right premolars. (B) A sectioned preoperative mandibular cast in the area of the missing teeth. (C) A separating disc being used to decorticate the crest of the ridge. (D) The threadformers used in the pilot holes to split the bone and to widen the osteotomy. (E) The completed osteotomy site with minimal reflection of the flap. (F) Six-week postimplant healing. The exposed cover screws do not pose a determent to healing. (G) A sectioned postimplantation cast showing significant bone expansion. Compare with Figure 3B.
Contributor Notes
Azfar A. Siddiqui, DMD, MSc, is the director of Maxillofacial Prosthetics and Mark Sosovicka, DMD, is an assistant professor of Oral and Maxillofacial Surgery at the School of Dental Medicine at the University of Pittsburgh, Pa. Address correspondence to Dr Siddiqui, 3459 Fifth Avenue, Suite 202 South, Pittsburgh, PA 15213.