When a 4.5x13 mm implant is being placed, it is deviated buccally.  With the implant being removed, the osteotomy is moved lingually with Lindamann bur and 4 and 4.5x13 mm drills.  When the implant is placed for the second time, the buccolingual position is acceptable; the depth is a little shallow (Fig.6).  Further adjustment of the depth appears to be acceptable (Fig.7).  After placing an abutment, an immediate splint provisional is fabricated between #18-20.  Three months postop, the split ridge appears to have healed with formation of apparent lamina dura distally (Fig.8 arrowheads).  Clinically the margin of the abutment (A) is supragingival.  A shorter cuff abutment should be used prior to impression.  There is no bone loss 5 months post cementation (Fig.9).  The 2-staged ridge split seems to be safer in term of bone resorption than the 1-staged one (2,3).

Ridge Split Last Next

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