EVALUATION OF BONE WIDTH CHANGE USING A TWO-STAGE RIDGE SPLITTING APRROACH IN NARROW POSTERIOR MANDIBULAR RIDGE (CLINICAL TRIAL)

Abstract

INTRODUCTION: Alveolar ridge splitting technique is a commonly used procedure for horizontal ridge augmentation of narrow ridges to allow placement of implants. However, the conventional one stage technique might randomly cause mal-fracture and necrosis of the fractured part in case the periosteum is detached from the distracted bone-plate. OBJECTIVE: to evaluate the effectiveness of the two-stage ridge splitting technique to preserve the blood supply and avoid necrosis of the expanded part. MATERIALS AND METHODS: Twelve patients were selected randomly presenting a posterior mandibular narrow ridge of less than 3 mm width. The sample was selected to match a list of inclusion and exclusion criteria. In the first stage, all patients underwent mandibular ridge splitting technique using piezotome. In the second stage, ridge expansion and implants were placed with only envelope flap. Assessment included measurement of bone dimensions and gain of bone width from the cone beam computed tomography. RESULTS: There was significant bone gain after the bone expansion measured at 2 weeks followed by some bone resorption at 4 months after implant placement. The bone density was increased at 4 months by average two times compared to the initial measurements in all patients. There was a significant increase between the primary implant stability at time of implant placement and 4 months after implant placement in all patients. All cases showed uneventful healing, except two cases, of which one showed soft tissue dehiscence and the other showed soft tissue infection. Both cases were managed conservatively. CONCLUSION: This study showed the staged ridge splitting approach to be safe and predictable therapy that might overcome possible complications of one-stage ridge-split procedures.