Ridge Expansion

Horizontal Ridge Expansion (ridge split)

Horizontal ridge expansion is done with 3-5mm.

4mm min for Class 1-2

3mm min for Class 2-3

Flex case has little cortical and nice cancellous bone.

How prevent rebound = wood screw not lag screw.

BTI Ultrasonic

General rules

  1. Ab 1 hour prior and 1 week
  2. CHX before and 1 week
  3. Max more likely single stage and mand more likely 2 stage
  4. (less than 5mm width do this or GBR) 3-5mm ideal but some can do 2mm

Single stage ridge expansion

Max (less than 4 teeth)  1st case should be 4-5mm wide and go to 7-8mm

  1. Crestal incision with papilla sparing no buccal flap
  2. Bone cut 8-12mm deep
  3. Optional mini screw stabilize plates open 10-12mm long
  4. Pack graft
  5. Collagen or PTFE
  6. Suture w/o tension and Periacryl
  7. 4-6 months later place implants

singel stage ridge expansion

Two stage ridge expansion

Mand Vumedi video Tulstunov

  1. Full thickness flap
  2. Peripheral buccal corticotomy creating buccal door 10-12mm below crest.  2mm deep
  3. Observe mental nerve location
  4. 3-5 weeks but 4 is ideal.
  5. Crestal incision with papilla sparing very minor buccal and lingual release
  6. Split 8-10mm with PTFE membrane used
  7. 4-6 months later place implants
buccal door

2 stage split ridge technique
First stage

  1. Full thickness flap
  2. Ultrasonic spoon around bone bed to stimulate bleeding
  3. Starting drill punch where future implants go
  4. Flat chisel side-to-side cut to connect all holes
  5. Expanders
  6. Graft everywhere

Second stage 4-6 months later

  1. BTI extraction kit to retrieve implants
  2. Repeat

Expect more bone loss in first year Bassetti 2014 JOMI

 

Some Horizontal Ridge Expansion References

Nice thread on DT from Sheldon

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