EC Dental Science

Introduction: Ideal implant placement is frequently impeded by an alveolar ridge that is too narrow. The lateral augmentation of the alveolar ridge is accomplished via alveolar ridge splitting, modified ridge splitting, bone expansion osteotomy, bone grafting, guided bone regeneration, and combinations of these methods.

Aims and Objectives: This research was conducted to assess the average labio-palatal width of the alveolar ridge before and after splitting with implant insertion, to compare the average labio-palatal width of the alveolar ridge between pre-prosthesis and post-prosthesis after six months; and to determine the mean labio-palatal width of the alveolar ridge prior to treatment and after treatment of implant placement.

Materials and Methods: Ten patients underwent treatment for single tooth replacement in the aesthetic zone through implant placement using modified ridge splitting and bone expansion osteotomy along with guided bone regeneration. Bone regeneration was accomplished using demineralized freeze-dried bone allograft (DFDBA) and a PRF membrane. In this research, we conducted modified ridge split bone expansion osteotomy with concurrent implant placement in the aesthetic area. The varied application of osteotomes and chisels alleviates the pressure at the crest by making chisel cuts slightly mesial and distal to the osteotomy. In contrast to segmental ridge splitting, there are no efforts to perform vertical osteotomy cuts. The osseous defect was packed with DFDBA and shielded by a PRF membrane after the appropriate-sized implant was inserted.

The patients were followed to see the response to rehabilitation clinically & radiographically for six months after loading of implant.

Results: The average pre-split labio-palatal width measured 3.70 ± 0.42 mm, whereas the average post-split labio-palatal width was 6.65 ± 0.47 mm. Consequently, the average increase in the crestal ridge following post-split was 2.95 mm. The average labio-palatal width before prosthesis was 6.15 ± 0.47 mm, whereas after prosthesis, it measured 5.95 ± 0.36 mm. Consequently, there was an average loss of 0.20 mm, likely resulting from the functional adaptation of the alveolar bone following implant loading. The labio-palatal width before treatment measured 3.70 ± 0.42 mm, while after treatment it increased to 5.95 ± 0.36 mm. Consequently, following six months of functional loading of the implant, there was an average increase of 2.25 mm in the labio-palatal width of the alveolar bone compared to the pre-split labio-palatal width of the alveolar bone.

Conclusion: Altered ridge splitting and bone expansion osteotomy combined with guided bone regeneration utilizing demineralized freeze-dried bone allograft and PRF membrane for dental implant placement in the esthetic zone demonstrated reliable outcomes when appropriate case selection and meticulous surgical techniques were applied.

 Keywords: Alveolar Ridge Augmentation; Dental Implants; Narrow Alveolar Ridge; Osteotomy; Ridge Expansion; Ridge Splitting

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