PubMed1997
One of the most frequently occurring problems in oral implantology, especially in the maxilla, is the reduction of the alveolar ridge, caused by bone resorption in the edentulous and partly edentulous maxilla. A usually successful but clinically sometimes complicated way of solving this problem is the augmentation of the resorbed parts of residual ridges, particularly when autologous bone is being used. Implant placement usually follows in a later stage. The bone-splitting and bone-widening technique, on the other hand, is a more obvious method for the immediate placement of implants in those cases where the dimensions of the residual ridge are reduced by only some degree. When the resorption of the residual ridge is extreme, this method can eventually be combined with guided tissue regeneration. Crestosplit instruments are specially developed osteotomes for cleaving and widening the crest of the residual ridge, whilst, at the same time, compressing the cancellous bone. In applying this procedure, a bone preparation can be made with dimensions very close to the diameter of the implant to be placed, and without losing important bone-parts as in the case of drilling. Upon the completion of this procedure, only the last drill with the dimensions of the implant has to be used and the implant can thus be placed in the same session. In edentulous cases where the resorption is almost nil, bone preparation with the aid of this method is also to be preferred as the compression of the corticocancellous bone will considerably increase the bone contact with the implant surface. Especially in the maxilla this will lead to a better prognosis of the survival rate of the implant and to better esthetic results of the final prosthetic restoration.