Basrah Journal of Surgery (Dec 2016)
EFFICACY OF SCREW EXPANSION FOR NARROW ALVEOLAR RIDGES IN DENTAL IMPLANT SURGERY, A CLINICAL STUDY
Abstract
Post-extraction alveolar ridge resorption is unavoidable phenomenon ending with insufficient ridge width. Bone grafting, osteotome ridge expansion and ridge splitting were used to expand narrow ridges but they are either expensive, associated with higher morbidity or require longer treatment time. Therefore the use of screw expansion was introduced as an option for managing deficient ridge width enhancing ridge density, facilitating immediate implant placement and is not associated with potential complication. The aims were to evaluate of the efficacy of bone screw expanders in widening narrow ridges, measuring bone gain and assessing possible complications. This clinical prospective study was performed between October 2015 & October 2016. Twenty four patients with 45 potential sites were involved. Preoperative clinical examination and radiographic assessment with OPG were performed for all cases. ITL bone expander kit was used after initial osteotomy to expand the narrow ridges. Osstell ISQ was utilized to measure the primary implant stability. After 16 weeks, patients were recalled again for the second stage surgery and Osstell was used again to measure the secondary stability. Patients then were referred to the prosthetic department for completion of final prosthesis after sufficient time for healing abutments in place. Twenty four patients were participated with 45 implants inserted. Female to male ratio was 2.4:1 with a mean age of 43.12 year ranging between 18–65 years. The original mean bone width (Mean±SD) prior to expansion was 3.3±0.56 mm & after expansion associated with dental implant insertion was 5.09±1.05 mm and there was statistical significance in possible mean bone gain by 1.79 mm from baseline. The overall survival rate was 91.1% with the anterior parts of both jaws having the highest percentages. Intraoperative complications involved cracks which were observed in 15 sites (39.5%) and cortical malfractures which were seen in 7 sites (15.6%). In conclusion, screw expansion is an easy solution for expanding narrow ridges with least possible complications and allow for simultaneous implant placement.
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