Split crest: immediate expansion rim technique for rehabilitation of atrophic maxilla. A case report

Deise Alves Kersten Ferreira, Carolina Amador da Silva Calandrini, Wagner Almeida Andrade

Abstract


While the deploy planning, we come across morphological changes in the intervention area and the bone volume, which is extremely important for the treatment outcome. The objective of this study is to describe the technique “Split-Crest” through a clinical case in which success was obtained. Demonstrate indications and advantages of the technique in order to gain a significant increase in bone density to achieve an excellent aesthetic and functional result. Female patient, leucoderma, 46 years old, attended the Dental Clinic of Specialization in Implantodontics of ESAMAZ, with report of early teeth loss and poorly adapted prosthesis in the upper anterior region of the pre jaw. During the clinical evaluation was observed Edentulism in the anterior arch of the jaw. Total tomographic filming was done on the jaws, the initial diagnosis was a severe resorption present in the premaxilla requiring regenerative process to achieve bone gain. During surgery the patient had immediate installation of previous implants in the region of the elements 12 and 22 through the technique of “Slplit-Crest”, which consisted of two vertical cuts on the vestibular cortical portion and longitudinal osteotomy followed by the the shift vestibular cortical-spongy plate. Eight weeks later, the patient had clinically significant bone gain, proving the viability and success of the technique. A minimally invasive surgical procedure with well executed manipulation of tissue grafts and accelerates the clinical outcome, the working hours by the end of the treatment is smaller, has lower morbidity and lower operating costs.

Keywords


Dental implants; Split crest; Osteotomy; Rehabilitation; Atrophic maxilla

Full Text:

PDF

References


Rocha S. Horizontal bone distraction. Dental Team Magazine. 2013; 6:28-37.

Simion M, Baldoni M, Zaffe D. Jawbone enlargement using immediate implant placement associated with a split-crest technique and guided tissue regeneration. Int J Periodontics Restorative Dent 1992;12(6): 463-73.

Misch CM. Implant site development using ridge splitting techniques. Oral Maxillofac Surg Clin North Am. 2004;16:65-74. https://doi.org/10.1016/j. coms.2003.10.001

Chiapasco M, Romeo E. Oral rehabilitation with implant-supported prosthesis for complex cases. Santos; 2007. p. 237-45.

Scipioni A, Bruschi MD, Calesini G. The edentulous ridge expansion technique: a five-year study. Int J Periodontics Restorative Dent. 1994;14(5):451-9.

Scipioni A, Bruschi GB, Giargia M, Berglundh T, Lindhe J. Healing at implants with and without primary bone contact. Clin Oral Implants Res. 1997;8:39-47. https://doi.org/10.1111/j.1600-0501.1997.tb00006.x

Scipioni A, Bruschi GB, Calesini G, Bruschi E, De Martino C. Bone regeneration in the edentulous ridge expansion technique: histological and ultra structural study of 20 clinical cases. Int J Periodontics Restorative Dent. 1999;19(3):269-77.

Misch CE. Divisions of available bone. In: Misch CE (ed). Contemporary implant dentistry. St. Louis (MO): Mosby; 1999. p. 98-9.

Triplett RG, Schow SR. Autologous bone grafts and endosseous implants. Complementary techniques. Int J Oral Maxillofac Implants. 1996;54: 486-94. https://doi.org/10.1016/S0278-2391(96)90126-3

Kayatt FE, Perez DS, Mosele OL, Mosele Jr. OL.Expansion of the alveolar process with sagittal split osteotomy for insertion of dental implants with a saw and chisel - Case report. Innovations Implant Journal. 2006;30-4.

Wijs F, Cune MS. Immediate labial contour restoration for improved esthetics: a radiographic study on bone splitting in anterior single-tooth replacement. Int J Oral Maxillofac Implants. 1997;12(5);686-96.

Spicioni A. et al., Bone regeneration in the edentulous ridge expansion technique: histological and ultra structural study of 20 clinical cases. Int. J. Period.Rest. Dent. 1999;19:269-77.

Sethi A, Kaus T. Maxillary ridge expansion with simultaneous implant placement: 5-year results of an ongoing clinical study. Int J Periodontics Restorative Dent. 2000;15(4):491-9.

Malchiodi L. et al., Rigid fixation by means of titanium mesh in edentulous

ridge expansion for horizontal ridge augmentation in the maxilla. Int. J. oral. Maxillofac. Impl. 1998;13(5):701-5.

Davarpanah M. et al., The modified osteotome technique. Int. J. Period. Res. Dent. 2001;21(6):599-607.

Oikarinen K. S. et al., Augmentation of the narrow traumatized anterior alveolar ridge to facilitate dental implant placement. Dent. Traumatol. 2003;19(1):19-29. https://doi.org/10.1034/j.1600-9657.2003.00125.x

Basa S, Varol A, Turker T. Alternative bone expansion technique forimmediate placement of implants in the edentulous posterior andibular ridge: a clinical report. Int. J. oral Maxillofac. Impl. 2004;19(4):554-8.

Engelke W, et al., Alveolar reconstruction with splitting osteotomy and microfixation of implants. Int. J. oral Maxillofac. Impl. 1997;12(3):310-8.

Coatoam G, Mariotti A, The segmental ridge-split procedure. J. Periodontol. 2003;74(5):757-70. https://doi.org/10.1902/jop.2003.74.5.757

Mayur S. Khairnar, et al., Modified ridge splitting and bone expansion osteotomy for placement of dental implant in esthetic zone. Contemp Clin Dent. 2014;5:110-4.




DOI: http://dx.doi.org/10.15448/1980-6523.2016.4.22153

e-ISSN: 1980-6523

ISSN-L: 0102-9460

 

This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE) http://www.publicationethics.org


SJR (SCImago Journal & Country Rank) IMPACT FACTOR:

SCImago Journal & Country Rank

Licença Creative Commons

Except where otherwise noted, content of this journal is licensed under a Creative Commons Attribution 4.0 International license.

 

Editorial Policies of Brazilian Scientific Journals. Deposit availability: Blue .

 

Copyright: © 2006-2017 EDIPUCRS