Clinical use of ridge-splitting combined with ridge expansion osteotomy, sandwich bone augmentation, and simultaneous implantation

Our aim was to describe and evaluate the outcome of ridge-splitting and simultaneous implantation combined with ridge expansion osteotomy and sandwich-bone augmentation in the aesthetic zone. Thirty-one patients aged from 21-55 years who presented with narrow edentulous ridges (2.88∼5.08 mm) were treated by ridge-splitting together with ridge expansion osteotomy and sandwich-bone augmentation to correct the osseous deficiency for simultaneous implantation. Bicon® implants were used. Calipers were used for biometric evaluation of the width of the ridge at both the first and second operations. Cone-beam computed tomography (CT, Morita, Kyodo, Japan) was used to assess the morphology of the ridge and the outcome of the operation. Forty-three implants were placed in the 31 patients selected, and none failed. At follow up all the implants functioned well and we saw no sign of gingival recession. Biometric evaluation at the surgical sites showed that the mean (SD) amount of augmentation of the ridge in the buccopalatal dimension was 2.8 (0.7) mm, p < 0.01). For a narrow edentulous ridge in an aesthetic zone, ridge splitting together with ridge expansion osteotomy and sandwich-bone augmentation is a reliable technique.