Cesar Luchetti and Alicia Kitrilakis
Department of Implant Dentistry. National University of La Plata. Argentina
Ridge splitting is a procedure used to expand the bone by separating the buccal and palatal plates.
It is normally performed in the maxilla using chisels, osteotomes and a mallet.
It could be done also in the mandible, but is a little bit more complicated due to the denser bone. In this case, is recommended to use a cutting disk or piezoelectric devices and threaded expanders, because these are less traumatic.
It is indicated when:
-The bone is less than 3 mm wide. (If we have more we normally can expand it just by means of osteotomes or expanders)
-The bone is enough to place an implant but we want to expand it for esthetics reasons.
Typically, the procedure is initiated by thin chisels, followed by wider ones and then osteotomes.
Residual spaces are filled with a bone graft.
A clinical case is showed below.
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Preoperative x-ray.
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Preoperative situation. A fistula is observed at canine level due to a root fracture. |
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Flap raised. A longitudinal fracture of the canine root is observed. |
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View of the narrow ridge after the extraction.
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Start of the ridge splitting with thin chisels.
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Ridge splitting with chisels.
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Initial ridge splitting.
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Continuation of the procedure by means of osteotomes to prepare the implants sites and to get the final expansion. |
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Continuation of the procedure by means of osteotomes to prepare the implants sites and to get the final expansion. |
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Final expansion.
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Comparison between the initial aspect of the ridge and the situation after the expansion. |
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Implants placed.
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Bone graft filling the residual spaces.
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Suture.
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Abutments in place.
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Definitive crowns.
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Pre and post operative comparison.
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Post operative x-ray.
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