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Controlled Ridge Expansion Using a Two-Stage Split-Crest Technique With Ultrasonic Bone Surgery

Anitua, Eduardo MS, DDS, PhD*; Begoña, Leire MSc; Orive, Gorka PhD

doi: 10.1097/ID.0b013e318249f50b
Clinical Science and Techniques

Purpose: The aim of this study is to evaluate the two-stage split-crest technique with ultrasonic bone surgery for implant placement in patients with very narrow ridges, and to determine the status of soft and hard tissues and implant success rate.

Material and Methods: Six patients received nine implants (BTI Biotechnology Institute, Vitoria, Spain) after a two-stage split-crest technique. Plasma rich in growth factors-Endoret was used during first and second stages to promote tissue regeneration. All implants were treated with plasma rich in growth factors-Endoret to promote osseointegration. Patients were recalled for clinical evaluation at least 6 months after implant loading.

Results: The status of soft tissues was very good showing adequate plaque index, bleeding index, and probing depth values. Success rate of implants at the end of follow-up (between 15 and 22 months after first surgery) was 100%. Bone ridge was measured and compared at final examination showing a mean ridge expansion of 5.60 mm (SD = 1.9) at apical and 7.33 mm (SD = 1.73) at occlusal.

Conclusions: Two-stage split-crest with ultrasonic bone surgery can be considered a safe and predictable bone expansion technique for very narrow ridges.

*Private Practice in Implantology and Oral Rehabilitation, Vitoria, Spain.

Researcher, Biotechnology Institute (BTI), Vitoria, Spain.

Researcher, Biotechnology Institute (BTI), Vitoria, Spain.

Reprint requests to and correspondence to: Eduardo Anitua, MS, DDS, PhD, Instituto Eduardo Anitua, c/Jose Maria Cagigal 19, 10005 Vitoria, Spain, Phone: 34.945160652, Fax: 34.945155095, E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.