Bone resorption following tooth loss is an obvious, continuous, and unpredictable process, which poses one of the greatest challenges in implant placement. The posterior regions of the jaws show more resorption compared to the anterior regions, with the mandible being affected more. Augmentation of the narrow alveolar ridge has been done using various techniques. The alveolar ridge split technique (ARST) is frequently used for the horizontal augmentation of the narrow ridge. In this case report, a 47-year-old female patient who had partial edentulism on the lower left jaw region associated with a narrow alveolar ridge was treated using the ridge split technique. A piezosurgical unit was used for splitting the ridge, followed by simultaneous implant placement. This alveolar ridge split technique is considered to be more predictable, reliable, and successful as compared to other techniques such as autogenous onlay bone graft and guided bone regeneration.

UNASSIGNED: This study aimed to assess the clinical and radiographic findings obtained by using amniotic membrane (AM) to cover nano-hydroxyapatite (nHA) bone grafts coated with platelet-rich fibrin (PRF) and thereby evaluate the osseointegration of posterior mandibular implants inserted simultaneously during alveolar piezoelectric ridge splitting technique (RST).
UNASSIGNED: A prospective cohort study was implemented with thirty patients who had a narrow posterior mandibular alveolar ridge and required implant restoration. Patients were distributed randomly into three groups (group I treated by piezoelectric RST and immediate implant insertion, augmented by the nHA bone graft only; group II treated by piezoelectric RST augmented by nHA bone graft and covered by AM; while group III was treated by piezoelectric RST augmented with PRF and nHA graft and covered by AM). Patients were evaluated clinically to assess the implant stability quotient (ISQ) and radiographically to assess horizontal ridge dimension, crestal bone level (CBL), and bone densitometric (BD) parameters.
UNASSIGNED: ISQ results showed a non-significant clinical difference between groups while CBL values showed a high statistically significant difference over the 12-month interval when comparing groups III and II with group I. BD outcomes showed statistically significant differences at all intervals in comparisons of group III with groups I and II.
UNASSIGNED: The results of this study suggest that concomitant use of PRF with nHA graft covered with AM for augmentation around the dental implant in a narrow posterior mandible after piezoelectric alveolar ridge splitting accelerate osseointegration and significantly increase bone density around the osseointegrated implant and decrease bone resorption in comparison to that achieved with the graft alone.

Anatomical variations often present a challenge in the placement of an implant in its optimal location. A ridge split procedure, which had been recommended for narrow alveolar ridges, has recently undergone a number of modifications, making the procedure simpler and providing more predictable outcomes. This article reports the 3-year follow-up of 2 implants placed using a ridge split procedure with a piezoelectric surgical unit for the rehabilitation of the mandibular posterior ridge.

OBJECTIVE: Edentulism is an incapacitating and irretrievable condition which can lead unswervingly to functional limitation, physical, psychological and social handicap. Maintenance of bone after tooth loss to improve retention, function, and performance of the restoration is a challenging task. The existence of a thin edentulous ridge signifies a clinical situation that is more complex for the placement of endosseous implants. Dental rehabilitation of the edentulous ridges with oral implants has become a routine treatment modality in the last few decades with consistent long term results.
METHODS: A staged ridge spilt procedure was performed in the maxillary posterior edentulous region employing piezosurgery for the augmentation of horizontal ridge deficiency which was followed by the successful placement of implant supported prosthesis.
RESULTS: At the 20 months follow-up, stable results were appreciated with minimal bone loss around the implants.
CONCLUSIONS: This proficient technique precludes the need for a second surgical site for the procurement of graft which in turn decreases patient discomfort. Hence this procedure can be used as an alternative to other strenuous procedures.

Onlay bone grafting, guided bone regeneration, and alveolar ridge split technique are considered reliable bone augmentation methods on the horizontally atrophic alveolar ridge. Among these techniques, alveolar ridge split procedures are technique-sensitive and difficult to perform in the posterior mandible. This case report describes successful implant placement with the use of piezoelectric hinge-assisted ridge split technique in an atrophic posterior mandible.

In long-standing edentulous cases, the alveolar bone generally demonstrates vertical and horizontal atrophy. Rehabilitating these patients with dental implants is difficult unless treatment is accompanied by some kind of augmentation procedures, all of which include specific disadvantages. One such technique, alveolar ridge splitting, is suitable only for enhancing ridge width. It has the advantage of reducing treatment time significantly, as implants can be placed simultaneously. This article offers a brief description of the procedure along with 3 case reports.

Narrow dentoalveolar ridges remain a serious challenge for the successful placement of endosseous implants. Several techniques for this procedure may be considered, such as guided bone regeneration, bone block grafting, and ridge splitting for bone expansion. The ridge split procedure provides a quicker method wherein an atrophic ridge can be predictably expanded and grafted with bone allograft or allograft, eliminating the need for second surgical site. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration which allows clean cutting with precise incisions. This case series describes reports of 2 such cases in which narrow mandibular ridge splitting was carried by mean of piezotome with immediate placement of implants in the osteotomy site. Five months later, the implants were uncovered followed by impression and restored with impant- supported porcelain-fused-to-metal crowns.

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.

Ridge splitting with bone expansion is a technique of manipulation of bone to form receptor site for implant without removing any bone from the implant site. Maxillary bone has inherent quality of flexibility which can bemolded to desire location by using series of instrument namely chisels and osteotome. This further improves quality of bone all around implant, at the crest and apex both. This article describes a report of a clinical case with management of bucco-palatal ridge defect with modified ridge splitting and expansion osteotomy technique using chisel and osteotomes in an esthetic zone.

BACKGROUND: Bucco-lingual resorption of the alveolar ridge can, at times, be predictably corrected at the time of implant placement. Among the different options available to achieve this are a group of surgical techniques described as split crest or split ridge procedures. Most of these procedures require the use of a mallet and some type of chisels and/or osteotomes; they are very technique-sensitive and can be uncomfortable for patients. Recently, alternative tools to split the crest have been presented, and these include the newer bone expanders and the piezoelectric scalpel. A flapless approach to implant dentistry has become popular with the aim to alleviate post treatment side effects, accelerate healing and avoid bone resorption caused by flap elevation.
METHODS: We present a technique combining the use of a piezoelectric scalpel and a tapered bone expander in a flapless fashion as a novel way to perform split crest procedures with an aim to optimize outcomes and acceptability by patients.
RESULTS: All implants were successfully placed and the resorbed ridge expanded in the same setting. Findings were confirmed by postoperative cone beam cat scan (CBCT) evaluation.
CONCLUSIONS: This new technique is a predictable approach for split crest procedures and has high acceptability by patients and is technically simple for surgeons.