Abstract:

Objectives: The aim of this study was to evaluate the immediate implant placement versus delayed implant placement 3 months later of the splitting of thin alveolar bone sites using flapless crest splitting technique on implant stability, width of crestal bone and bone density and efficacy of piezotome ridge splitting in avoiding injury of the adjacent nerve.

Patients and methods: This study was designed as a prospective clinical trial of 35 implants over 8 patients with 16 alveolar splitting sites. Eight sites were splitted and immediately implanted and submitted to group I, the another eight sites were splitted and implanted after 3 months they were submitted to group II, After alveolar ridge splitting both groups were grafted via xenografts and covered with collagen membranes for guided bone regeneration (GBR). For both groups we clinically assessed insertion torque, Implant stability quotient (ISQ) and radiographically horizontal bone gain and bone density at 3 intervals postoperatively, 3 and 6 months. Statistical comparative t-tests were performed to compare between two groups according to the above mentioned parameters.
Results: The mean ISQ and insertion torque ± SD in group II was higher than group I.horizontal bone gain, group I showed a higher increase in bone gain than group II. group Iand group II had showed statistically significant increase in mean bone density postoperative, after 3 and 6 months (p<0.001*). group II had showed statistically significant increase in mean bone density postoperative, after 3and 6months (p<0.001). No cases in our study using piezotome alveolar ridge splitting had injury of the adjacent nerve.

Conclusion: Immediate implantation after piezotome ridge splitting can be a useful procedure in ridges which have low bone quality and a thin cortex. Delayed implantation after piezotome ridge splitting is recommended when the initial stability of the implants is predicted to be poor. Both techniques using piezotome alveolar ridge splitting are effective in avoiding adjacent nerve injury.