Case Summary 🔎

Patient Information

• Age/Gender: 58-year-old female

• Systemic Condition: No underlying systemic disease

Clinical Findings

• Tooth Site: #46, #47

• Diagnosis: Generalized periodontitis

• Findings: Horizontal bone loss on #46, #47

Treatment Plan

• As extremely narrow ridge was found on the mandibular right quadrant, ridge split was performed and decided to place IS-III active implant.

Utilized Components

• 

  The following components from the Ridge Wider Kit were utilized:

  • Safe Disk (Non-Saw Type): Used for cutting across the narrow ridge.

  • Bone Expander: Used for sequential bone expansion.

  • Bone Trimmer: Used to flatten and smooth the narrow alveolar crest.

Conclusion

• The Safe Disk and Bone Expander from the Ridge Wider Kit enable safe and effective horizontal expansion and simultaneous implant placement in narrow ridges.

• Before & After

Case Presentation

1️⃣ Pre-Op

• A pre-op panoramic radiograph shows bone loss in the #46 and #47 regions.

2️⃣ Surgery

[Flap Elevation]

• fig 1. Due to horizontal bone loss, the alveolar ridge is extremely narrow. Expansion of the ridge using the Ridge Wider Kit is necessary to facilitate implant placement.

• fig 2. Flap reflection was performed to access the underlying bone and prepare the site for implant placement.

fig 1

fig 2

[Osteotomy]

• fig 3. A Safe Disk (Non-Saw Type) Ø10.0mm was used to cut across the narrow ridge.

• fig 4-5. A Safe Disk (Non-Saw Type) Ø7.0mm was used to cut the buccal side before alveolar bone expansion.

• fig 6-7. A Safe Disk (Saw Type) Ø7.0mm, T1.0mm was used to cut the lower part of the buccal area to a thickness of 1mm before bone expansion to prevent alveolar bone fracture.

  • Recommended speed for the Safe Disk: 1,200 rpm

fig 3

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fig 7

[Ridge Expansion]

• fig 8. A Bone Chisel was used for the initial ridge expansion. Slight expansion of the ridge was achieved by inserting the chisel between the cortical plates. Additionally, the remaining attached bone was separated.

• fig 9. A Bone Trimmer was utilized to flatten and smooth the narrow alveolar crest. The side blades allowed for efficient trimming of the alveolar crest.

  • Recommended operating speed for the Bone Trimmer: 1,200 rpm

• fig 10. A Ø1.5 Initial Drill was used for initial drilling.

  • Recommended speed for the Ø1.5 Initial Drill: 1,200 rpm

fig 8

fig 9

fig 10

• fig 11-12. A Bone Expander was used for sequential bone expansion.

  •  Recommended speed for the Bone Expander: 25~35rpm

fig 11

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[Implant Placement]

• fig 13. A CMI IS-III Active Ø4.5×10mm fixture was placed in the #46 region.

• fig 14-15. A Neo EZ-GBR Kit Ø1.5 Drill was used to prepare for the fixing screw insertion, and a 7mm fixing screw was then inserted.

• fig 16. A CMI IS-III Active Ø4.5×8mm fixture was placed in the #47 region.

fig 13

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fig 16

[GBR]

• fig 17-18. Two implants were placed with an initial stability of 15 Ncm, followed by bone grafting.

• fig 19-20. A resorbable collagen membrane was then placed over the graft, and sutures were placed to complete the surgery.

fig 17

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3️⃣ Post-Op

• Post-op panoramic radiograph

• Three months after GBR, the defect area was fully filled with new bone. Healing abutments were then connected, and sutures were placed.

4️⃣ Final Restoration

• The final restoration was completed with zirconia three months after surgery.

5️⃣ Clinical Video