Maxillary ridge expansion for dental implant placement with alveolar corticotomy

Abstract

Maxillary ridge transversal expansion is based on osseous plasticity obtained by corticotomy. It allows progressively for an adequate transversal intercortical diameter large enough to insert one or several dental implants. We present a pre-implant maxillary ridge transversal osseous expansion technique. Surgical technique: Surgery is carried out under local or general anesthesia. Infiltration of a local anesthetic with adrenaline reduces bleeding and facilitates dissection. One horizontal crestal and two vertical vestibular surgical incisions are made in the mucosa. The operating site is exposed by lifting a mucoperiostic flap. Two vertical osteotomies are performed 2 mm away on either side of the future implant and one horizontal crestal osteotomy. A guided bone fracture following the osteotomy lines is performed with an osteotome. An alveolar bone flange with a superior hinge is thus obtained. If implant placement is immediately possible, the implant bed is made with the osteotomes and/or drill. An osseous graft is inserted in the intercortical space around the cervical implant area and in the corticotomy zones. The mucosa is sutured on a resorbable collagen membrane. Discussion: The indications are maxillary crestal thickness ranging from 1.5 to 3 mm. This technique allows gaining 4 to 5.5 mm of thickness on a length of up to 40 mm. Implants are often placed during the same surgery. Morbidity is limited and aesthetic prosthetic results are satisfactory. © 2008 Elsevier Masson SAS. All rights reserved.