implants international magazine of oral implantology

I case report Figs. 1a & b_The countersinks (expanders) of the bone (a) and the conical implant (b). Figs. 2a & b_Sinking of the bone (yellow arrow) before the surgery (a) and the radiograph thereof (b). Fig. 3a–c_Bed preparation with a lance-shaped drill until planned depth was reached. Fig. 4a & b_Sequence using the 3.5 mm expander. _Introduction Tooth extraction changes the height and thickness ofthealveolarbonesignificantly,especiallywhentooth lossistheresultofdentaltrauma,periodontalinvolve- ment, or when the vestibular wall is lost during extrac- tion.1 Bonedeficienciesmayhamperorpreventtheuse of dental implants owing to insufficient bone volume forholdingimplantsofanappropriatesize2,3 orinaes- thetic areas, hampering an adequate treatment of the case.4 To correct this situation, various surgical proce- dureshavebeenproposed.Bonegrafts,5 membranesfor guided bone regeneration6 and a combination of both of these techniques7 have been used to increase bone volume. Even though there is ample documentation on the success of bone grafts and membranes in terms of the number of cases and follow-up after the placement of implants in grafted areas, these procedures have some disadvantages,suchtheneedforextra-oralorintra-oral bone, increased morbidity, risk of exposure and infec- tionofthegraftormembrane,andanunpredictablerate ofboneresorptionafterimplantplacement.8,9 Thus,sur- gicalalveolarridgeexpansionwasproposedasanalter- native in order to allow the placement of implants.10 Withtheaidofhandtools,alongitudinalfractureisper- formed in the atrophic ridge, dividing it into two parts and thereby increasing its thickness for implant place- ment.Throughthepresentationofclinicalcases,thisar- ticle aims to demonstrate and evaluate a simple tech- niqueforincreasingthebonevolumeinnarrowedareas withtheuseofconicalimplantsandboneexpanders. _Materials and methods Twopatientswithmissingteethindifferentregions of the maxilla were selected. These patients, besides Bone expansion in one surgical step Author_Prof Sergio Alexandre Gehrke, Bruno Konig Jr., Brazil, & Giovanni Wiel Marin, Italy 26 I implants2_2012 Fig. 1a Fig. 1b Fig. 3b Fig. 4a Fig. 2a Fig. 3a Fig. 3c Fig. 4b Fig. 2b