Two-Stage Bone Expansion Technique Using Spear-Shaped Implants Associated With Overlapped Flap: A Case Report
The conventional method of ridge expansion uses a mucoperiosteal flap elevation to allow bone corticotomy, which is followed by bone expansion performed with chisels and bone expanders. To facilitate corticotomy and avoid flap elevation, bone expansion can be performed in 2 stages. This case report presents a modified 2-stage bone expansion technique to achieve better implant stabilization and wound closure. This modified approach may be an efficient procedure for minimizing complications.
Figure 1. Initial tomography. Figure 2. (a) Osteotomies performed vertically. (b) Osteotomies performed on the crest of the ridge. Figure 3. (a) Incision to perform the overlapped flap. (b) Flap raised only sufficiently to see the bone crest. Figure 4. Use of a thin chisel to separate the plates. Figure 5. Expander in position. Figure 6. Thin pointed implant.
Figure 7. (a) Implants in place. (b) The area between the plates was filled with inorganic bovine bone. Figure 8. Sutured flap. Note the center of the conjunctive tissue taken from the palate. If the overlapped flap had not been performed at the end of the surgery, it would not have been possible to cover the area because of the increased bone volume caused by the expansion. Figure 9. Computerized tomography performed after 6 months. Figure 10. (a) Six months after the denture was placed. (b) Radiography after 30 months of loading.
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