Ridge Splitting: Ridge Augmentation Without Grafts or Membranes

Ridge Augmentation is a commonplace procedure to rebuild bone lost when teeth are removed.



Note the concavity caused by removing a tooth

The goal of implant treatment is not only to successful insert the implant and fabricate a crown on it so the patient can function in comfort, but to missing bone, gum tissue, and to have the implant “emerge” out of the bone like a natural tooth.



The expanded ridge restores the missing bone and gum tissue.

demonstrates the post-operative result after an implant has been inserted, the atrophic ridge expanded by a ridge splitting technique, and the crown is inserted.



The goal is to make the implant crown, including its supporting tissues, indistinguishable from a natural tooth and its tissues. In this case, the implant crown is on the right.
In most cases with severe alveolar bone loss, a procedure – known as ridge augmentation – is commonly performed to increase the width of the atrophic ridge by using bone grafts and a membrane. The healing time for this prodecure is roughly six months. This long healing time delays the time when the final restoration can be fabricated and inserted, and it is costly. An alternative is to expand the ridge via a special technique that reduces the healing time, is less costly, and yields a predictable, lasting result.
Another example of ridge splitting that helps to restore lost tissues caused by the removal of a tooth can be seen.



Note the “dished in” or caved in appearance caused by the removal of the left central incisor.



Notice how the lost tissues have been restored via ridge splitting, recreating normal root anatomy, normal gingival architecture, and an esthetic crown.

demonstrate an atrophic ridge. Without performing some form of bone enhancement, the implant would be inserted in an unfavorable position. Biting forces could be deleterious and oral hygiene measures could be difficult. Esthetics would be severely compromised. Under most circumstances, dental surgeons try to correct this defect with a ridge augmentation procedure that utilizes expensive materials and takes a long time to heal. An alternative, known as ridge splitting, enables the skilled clinician to expand the ridge and, at the same time, insert a dental implant without the need for either bone graft material or a membrane known as GBR or Guided Bone Regeneration technique.



Note the compressed ridge where the tooth is missing. If the implant is inserted in this bone, without changing its width, the implant will be too palatal and out of alignment.



demonstrates how the ridge is expanded and a space opened wide enough to insert a dental implant.



demonstrates the bone flap created by the ridge splitting and the implant being inserted.



Thisi is a cross-sectional 3D image of the implant after 3 months of healing. Notice that the “bone flap” has healed and remains present.
While ridge augmentation and GBR is acceptable and well-documented technique, ridge splitting accomplishes the same goals of recreating both lost hard and soft tissues without using expensive materials or taking a long time to heal. While technique sensitive, ridge splitting is atraumatic and simpler for the patient, with a predictable outcome.

*These images are from author’s previous practice.