Staged Ridge Splitting Technique for Horizontal Expansion in Mandible: A Case Report
Ridge split procedures are commonly performed for horizontal augmentation of narrow ridges which would otherwise preclude implant placement. A 47-year-old patient with bilaterally edentulous posterior mandibular ridges was treated in the Department of Periodontology and Implantology, M.A. Rangoonwala College of Dental Sciences and Research Centre, employing a “staged ridge split” technique. In this technique, a simple corticotomy at the crestal, apical, and lateral aspects of the buccal cortical plate of the mandible was performed. Following this, a month later, the ridge was expanded and bone graft OssiFi containing biphasic beta-tricalcium phosphate and hydroxyappatite was placed to maintain the gap between the cortices. Thereafter, implants were placed 3 months later. A successful prosthetic rehabilitation was done following a healing phase of 3 months. This approach leads to restoration of function with a predictable outcome and minimal risk of cortical plate fracture during the ridge expansion process.
Figure 1. Preoperative occlusal view showing inadequate width of the ridge bilaterally. Figure 2. Orthopantomogram. Figure 3. Stage I – Corticotomy with crestal, vertical, and apical horizontal cuts. Figure 4. Stage II – ridge split after 1 month. Figure 5. Bone graft (OssiFi) placed. Figure 6. Postoperative occlusal view showing 3 mm increase in width of ridge bilaterally. Figures 7 and 8. UniTi implants placed within sound bone and excellent ridge expansion can be appreciated.
Figures 9–11. Prosthetic rehabilitation. Figures 12 and 13. Intra-operative periapical radiograph showing well osseointegrated loaded implants.
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