Dental Implants: Thin Ridge Placement
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Hi,i have a patient with Oligodontia. My problem that his ridge is very thin, about 2mm? How do I improve this? Onlay graft , gbr technique or something else? Any help would be appreciated. Please leave your comments below.
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15 Responses to “ Dental Implants: Thin Ridge Placement ”
If the vertical ridge height is sufficient, I prefer to gbr the site with regeniform and a goretex membrane because it has always been predictable for me. I have also utilized edentulous ridge expansion (ridge splitting) for the maxillary posterior areas, but it is much more technique sensitive. Onlay grafts also require a lot of experience to get consistent results.
I’ve done it with all types of ways, but mainly resort to GBR with a mix of autogenous and Puros, Regenform works well too. As an aside, i recently had the chance to point blank ask Dr. Mellonig his preference and his was GBR technique mixed with Emdogain and mixture of FDBA/DFDBA. That’s been my most predictable way, but it was nice to hear from the master!!!
as your ridge is only 2mm thick you better do a gbr with a mix of autologous and DFDBA
you can use the expansion technique in cases more than 3mm
the key factor is not to elevate the flap and first separate both the cortex properly. you may need sometimes to separate with thin fissure bur and use thin flat osteotomes
I have a lot of experience treating oigodontia within hospital practice. It would be helpful to have more clinical information such as the precise site of the problem. Is there just a horizontal deficiency or is there a vertical component?
awesome! I like this interaction
I will recommend you to place the implants just behind and in contact with the alveolar ridge, with pal exposed threads. It preserves the hight of the ridge and it gives stability to lateral forces. Just the same procedure as the front fixtures together with Zygoma treatment. Contact me and I will give you references.
You may want to contact Dr Don Callan He has a good technique to correct this problem.
Using reinforced Gortex and bovine bone. I use Bio-Gide for all other procedures that require a membrane. Have used Emdogain in the past but too unpredictable! Just bought new human growth factor GEM21.
sounds like you will need to augment at least 5-6 mm of bone in order to have a 4 mm implant. To get that thickness with a gbr will be tough! Block graft from the chin would be my first choice. Ramus would not be thick enough. PRP a must!
I have switched to Regeneform and Regenefill…. I have a bunch of Emdogain and thinking of mixing it with Perioglas or the HTR24 I have in my storage. Any thoughts?
I am using Resolut GTR with sinus augmentation and Regeneform. Any improvments?
Randy,
Contact Dr. Robert Horowitz.
He is very experienced in applications of Regeneform,Emdogain,Cal-matrix.
I am planning on doing site augmentation for a future #9 implant. The CT shows about 3 mm of bone, I was deciding between particulate with tacks or J block. Any Thoughts?
I have experienced similar situation and i recommend the use of finger bone-expanders.They will allow increasing the horizontal defect,if there is vertical defect also you can place autogenous bone with PRP.
I have used finger bone expanders and it gives good results with similar cases but if there is vertical defect also you can place autogenous bone combined with PRP.
I am an omfs. I find the best bone to use for onlay grafts, depending on the site and the number of implants, is without doubt a small piece of anterior iliac crest-inner table. The results are predictable. If your technique is perfected there is often very mild post operative pain and discomfort.
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