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Ridge Expansion Procedure |
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Technically, the Ridge
Expansion procedure is not really a bone
grafting procedure, because no bone graft is
being utilized. However we do expand bone
volume by means of "stretching" the outer bone
plate. Since the result is an increase in
bone volume, we listed this procedure under bone
grafting procedures.
This type of procedure is
illustrated below. The instruments and
implant in this particular case are somewhat
different form more conventional ones, however
the concept is still the same. Please keep
in mind that these images are somewhat graphic
in nature. |
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The image to the
left shows a direct view of the missing incisor. The
blue tangential lines show the esthetic defect on the
ridge. In this case we decided to place a special
implant designed for ridge expansion procedures, as
shown on the right. |
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The left
and right images show the instruments used to
expand the ridge. No drills are used in this
technique. These instruments are driven into
the jaw ridge, one by one, starting with the
smallest one in diameter, until the ‘hole’ is
big enough to place the implant. This will also
expand the outer part of the ridge, by bulging
it out. |
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The right
picture shows one of the ‘expansion’ instruments
after it has been driven into the bone. |
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Once the
final ‘expander’ is driven into the ridge,
try-in pins are used to determine the correct
angulation for the future abutment, onto which
the tooth will be cemented. |
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After
the try-in pins are verified, the implant is
inserted and the tissues re-sutured. As you can
see on the left, this procedure is minimally
invasive. On the right you can see the implant
after two weeks of healing. Note the difference
in ridge width (as shown by the tangential line
again) in comparison to the original ridge. |
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Above are the ‘before’ and
‘after’ x-rays, to the left and right,
respectively. Note the "white" implant in
the previously toothless space. |
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These
two images show on a transverse-sectional CT
Scan how much bone we gained by this procedure.
On the left you can see the pre-surgery
condition. A reference line drawn from the pulp
chambers of the adjacent teeth (blue) and a
perpendicular line at the future implant site
out towards the ridge shows us approximately 1mm
of bone. If we compare this value to the one on
the right side, which shows the post-operative
CT Scan, we have approximately 7mm from the
reference line, so we gained approximately 6mm
of bone width. |
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The above
technique can sometimes be used instead of the
Onlay Graft technique,
which is in general a much more invasive
procedure. The Ridge Expansion procedure
is a little more technique-sensitive, however,
since fracture of the outer bone plate may
compromise the integration of the implant. |
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