PMC10072968_01
Pre-operative radiographic views (Case 1). (a) Panoramic view. (b) and (c) CBCT view. The height of alveolar bone was sufficient, but it can be seen that the width was somewhat narrowed.
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fig1
An extraction was planned after further evaluation of this tooth (Figure 1).
Intraoral views of alveolar ridge split technique with ridge preservation (Case 1). (a) Pre-operative clinical gingiva. (b) Alveolar bone was split and expanded with chisel.
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fig2
Tapping Kit (ESSET Kit) , Osstem, Korea), vertical (mesial area) and lateral osteotomies were performed on the maxillary alveolar buccal bone plate using a microsaw. Then, the buccal bone plate, on which ridge splitting was performed, was expanded in the buccal aspect using a chisel (Ridge Split Kit , Osstem, Korea) by 3 ~ 4 mm (Figure 2).
Periodic follow-up at 4 months after operation (Case 1). (a) Intra-oral view. (b) CBCT view. The width of the alveolar bone had increased.
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fig3
Periodic follow-up found that the bone graft was stable at 4 months, as observed on radiographs (Figure 3), and implants were subsequently placed (TSIII Sand blasted with alumina and Acid etched surface (SA) 4.0 x 8.5 mm, 5.0 x 10 mm, Osstem, Korea) (Figure 4).
(a-c) Post-implantation radiograph views (Case 1). The width of the alveolar bone was well-maintained, and the implants were placed.
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fig4
Periodic follow-up found that the bone graft was stable at 4 months, as observed on radiographs (Figure 3), and implants were subsequently placed (TSIII Sand blasted with alumina and Acid etched surface (SA) 4.0 x 8.5 mm, 5.0 x 10 mm, Osstem, Korea) (Figure 4).
Intraoral and panoramic views after prosthetic rehabilitation (Case 1). The prostheses were maintained well without any specific complications during the follow-up period.
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fig5
As the implant stability quotient (ISQ) value measured using an Resonance Frequency Analysis (RFA) device was 75-80, suggesting stable implants, prosthetic rehabilitation with full zirconia crowns was fabricated (Figure 5).
PMC10072968_02
Pre-operative panoramic view (Case 2).
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fig6
Radiographic examination revealed a narrowed alveolar ridge in the left mandibular posterior area, which required extraction of the left mandibular first molar (Figure 6).
Postoperative intraoral (a) and radiograph views (b) (Case 2). The width of the alveolar bone was well expanded, and we can see that the implant had been placed in the right direction.
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fig7
In order to achieve a tension-free suture, a periosteal-releasing incision was performed to extend the flap, and after that, the interrupted suture was done (Figure 7).
Final prostheses were delivered (Case 2). The prostheses were maintained well without any specific complications during follow-up period.
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fig8
For the final prosthetics, porcelain-fused-to-metal crowns were fabricated (Figure 8).
PMC10072968_03
Pre-operative radiographic views (Case 3). In the CBCT view, it can be seen that the width and height of the alveolar bone are atrophied.
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fig9
The buccal bone was found to be considerably atrophied by clinical and radiological evaluations (Figure 9).
Intraoral views of the alveolar ridge splitting technique with guided bone regeneration (Case 3). (a) Pre-operative site of gingiva. (b) Alveolar bone splitting and expanding with chisel and GBR were done.
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fig10
In order to achieve a tension-free suture, a periosteal-releasing incision was performed to extent the flap, and after that, the interrupted suture was done (Figures 10 and 11).
Postoperative CBCT view, showing that the width of the alveolar bone had increased (Case 3).
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fig11
In order to achieve a tension-free suture, a periosteal-releasing incision was performed to extent the flap, and after that, the interrupted suture was done (Figures 10 and 11).
Post-implantation radiograph views (Case 3). The width of the alveolar bone was well-maintained, and the implant was placed.
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fig12
After periodic follow-up, bone graft was found to be stable at 7 months, as observed on radiographs, and implants were subsequently placed (TSIII SA 4.5 x 8.5 mm, Osstem, Korea) (Figure 12).