Two-Staged Ridge Split

A 48-year-old lady has lost the lower right 2nd molar (Fig.1 CBCT).  The crest is narrow (Fig.2 (coronal section): <), approximately 2-3 mm wide (Fig.3).  When a 4.5x10 mm UF implant is placed, the buccal threads should be exposed (Fig.4). 

To preserve the coronal buccal plate, a two-staged ridge split will be performed.  At the 1st stage, the ridge is to be sectioned as shown in red lines in Fig.5.  Two to three weeks later, a chisel or bone expander will be used to pushed the sectioned segment buccally (Fig.6 yellow).  As the osteotomy increases in depth and diameter and the implant as mentioned above (Fig.4) is placed (Fig.7 green), the segment is being pushed further, while it is still contacting the implant.  One of the opposing dentition, #3 also needs implant.

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Xin Wei, DDS, PhD, MS 1st edition 12/13/2015, last revision 12/13/2015