Discover a different ridge splitting technique that could shorten the overall treatment period.

Various Ridge Splitting Technique using the ESSET KIT

By: Kyung-Tae Park, Sang-Yeup Lee, Yong-Jin Kim


Introduction:

The ridge splitting technique aims the creation of new implant bed by longitudinal osteotomy of the alveolar bone. The buccal cortex is repositioned laterally by greenstick fracture, and the space between the buccal and lingual cortical plates fills with new bone, thus enlarging the width of the alveolar ridge. The traditional ridge splitting method using chisel lacks precision and it is difficult to control. In addition, the chisel method lacks initial implant stability.


Case Report 1

Without Vertical Osteotomy
Age / Sex : 80Y / F
Chief complain: Ill fitting mandibular RPD
Past medical history: HTN
Past dental history: Mandibular RPD treatment 10 years ago
Treatment plan: Ridge splitting with the ESSET kit & simultaneous implant placement

Pre-operative radiograph & Intra-oral view.Fig. 1-2. Pre-operative radiograph & Intra-oral view.
Intra-operative-view. Intra-operative-view. Intra-operative-view. Fig 3-10. Intra-operative view. Full thickness mucoperiosteal flap was elevated with crestal incision and one vertical incision on the buccal side of the residual alveolar ridge distally
2nd stage surgery was done 12 weeks after implant placement.2nd stage surgery was done 12 weeks after implant placement.Fig 11-14. 2nd stage surgery was done 12 weeks after implant placement.
Final prosthesis was placed 14 weeks after implant placement.Fig 15-16. Final prosthesis was placed 14 weeks after implant placement. Gingival condition around implants looks healthy. Marginal bone level implants is well maintained until POD 1 year and expanded alveolar bone volume around implants is also well maintained.

Case Report 2

Single Vertical Osteotomy
Age / Sex: 36Y / F
Chief complain: Partial edentulism
Past medical history: N / S
Past dental history: Mandibular RPD treatment 5 years ago
Treatment plan: Ridge splitting with the ESSET kit & simultaneous implant placement

Pre-operative radiographFig 1-2. Pre-operative radiograph
Intra-operative-viewFig 1-2. Pre-operative radiograph
Intra-operative view Full thickness mucoperiosteal flap was elevated with one vertical incision on the mesial side.Intra-operative view Full thickness mucoperiosteal flap was elevated with one vertical incision on the mesial side.Intra-operative view Full thickness mucoperiosteal flap was elevated with one vertical incision on the mesial side.

Fig 6-14. Intra-operative view. Full thickness mucoperiosteal flap was elevated with one vertical incision on the mesial side. Vertical alveolar bone reduction was performed with a crestal remover until horizontal bone volume of at least 3mm~4mm was secured.
Final prosthesis was placed 14 weeks after implant placement.

Fig 15-18. Final prosthesis was placed 14 weeks after implant placement. Horizontally increased alveolar bone volume and keratinized gingiva around prosthesis are well maintained. In the CT scan, the sufficient amount of expansion around both the first premolar and the first molar areas is seen.

Case Report 3

Double Vertical Osteotomy
Age / Sex: 66Y / F
Chief complain: Ill fitting mandibular RPD
Past medical history: HTN, DM
Past dental history: Mandibular RPD treatment 8 years ago
Treatment plan: Ridge splitting with ESSET kit & simultaneous implant placement

Pre-operative radiograph & Intra-oral viewFig 1-2. Pre-operative radiograph & Intra-oral view
Intra-operative viewIntra-operative viewIntra-operative viewIntra-operative viewFig 3-12. Intra-operative view

Conclusions:

Our case reports demonstrated that the new alveolar ridge splitting technique using ESSET KIT is simple & effective in longitudinal expansion of the alveolar ridge in cases of alveolar atrophy and knife-shaped ridges.

These results indicate that the new alveolar ridge splitting technique using ESSET KIT is a valid procedure for augmentation of atrophic and knife-shaped alveolar ridges and could shorten the overall treatment period in comparison to traditional ridge splitting method.

Also, In certain situations, conventional ESSET kit technique could be modified for more alveolar bone expansion. In cases where enough amount of expansion is needed, one or two vertical osteotomy can be made.

 

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