Two weeks later, small incision is made on the crest.  Limited exposure to the crestal bony cut is provided.  A curved chisel is used to try to split the crest.  It feels more likely that the lingual plate is fractured.  A starter drill and 2 mm initial drill are used for osteotomy 12 mm deep from gingival margin (Fig.4 (red line: the superior border of the Inferior Alveolar Canal)).  The 2 smallest bone drills from Esset Kit (Hiossen) are used with purpose to push the buccal plate buccally.  Sequential osteotomy is finished until 4x13 mm drill with stopper.  With soft tissue interference, the depth is assumed not enough.  A 2.7 mm drill is re-used with intention to go down for 16 mm.  Because of soft bone, the drill dropped deeper than expected (Fig.5). 

Ridge Split Last Next

Xin Wei, DDS, PhD, MS 1st edition 03/12/2016, last revision 08/13/2020