Modification of mandibular ridge splitting technique for horizontal augmentation of atrophic ridges

PURPOSE: A two stage approach of ridge splitting and lateral expansion in the mandible to achieve enough bone width for the purpose of dental implants is presented. MATERIALS AND METHODS: A total of 13 consecutive patients with 16 long-span edentulous areas of the mandibular ridge were included in this study and 42 dental implants were inserted. Corticotomy of a rectangular buccal segment was carried out followed by 3 weeks of recovery; the mandibular ridge was stretched laterally, leaving the buccal periosteum attached to the lateralized segment. In this modification, there was no need for the use of grafted foreign materials to fill the defect and neither the use of barrier membranes, since it was treated practically as a fresh extraction site. To prevent the undesirable movement of the lateral plate, a small chip (2-3 mm in diameter) of bone spacer was properly fixed. The dental implants were placed 3-5 months later on. RESULTS: Approximately, 86% of the expanded areas were successful in providing an adequate width to accommodate an implant. The average gain in width was 3.22 ± 0.97 mm. All intended implants were inserted. Prosthetic loading with fixed prosthesis was successfully implemented in all cases. CONCLUSION: This modified technique is a simple and short procedure with satisfactory results and minimal morbidity. Of note, this approach is devoid of foreign materials usage and has a low rate cost, therefore, should be employed more often.