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Ridge Expansion Instruments: Safe for D-1 or D-2 Bone?

posted in advice, Instruments for Implant Dentistry

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Dr. N. asks:
Are ridge expansion instruments safe for D-1 or D-2 bone of the lower posterior arch? I have used these for D-3 and D-4 type bone in the maxilla but have been reluctant to do so in the mandible due to concerns of fracturing of the buccal plate on the harder and more dense bone bone. Any comments?

8 Responses to “ Ridge Expansion Instruments: Safe for D-1 or D-2 Bone? ”

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID May 5th, 2009

  
  

  Check out the instruments and techniques of Dr. Hilt Tatum.

• Peter Fairbairn May 5th, 2009

  
  

  Also look into Meissinger of Germany , some progressive ideas

• William May 5th, 2009

  
  

  Actually it is easier in softer bone. The question will always be, even with expansion and condensation, implants in type IV bone, how well will they integrate, how will they respond under load and what is the osteogenic potential of the patient.

• Bruce G Knecht May 5th, 2009

  
  

  To properly expand the lower ridge, you must split the ridge at the crest with a Piezo, bone Saw, or a 701 surgical bur to the medulary boneYou also may nee to make vertical releasing cuts at the proximal edges of teh crestal cut. I wil use Tatums D expanders and the Mesenger kit. The boen can fx and if it does you can use fixation screw to hold it(this is very difficult so don’t think that it is an option). It is not easy to expand and you need to have a large area to get good expantion. Hope this helps

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID May 6th, 2009

  
  

  You can start your inital bone cut with a saclpel blade, using a mallet, then follow with osteotomes and proer osteotomy bur between osteotomes.

• SV May 12th, 2009

  
  

  Ck this site. I like this technique.
  http://www.bicon.co.uk/casestudy.jsp?ref=10

• rajesh May 22nd, 2009

  
  

  expantion of d1 and d2 bone is a bit riskey by using con ventional expanders and oesteo tomes how ever pieso tips are best in such situations missinger expanders are riskey as base expantion is more chanceto fracture is too hi in d1 d2 may be stoma is better

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID May 22nd, 2009

  
  

  Rajesh, The bone in the mandible is just as plastic as that of the maxilla. You can expand the bone with the osteotomes from Tatum Surgical. You have to implant for rxery other tooth on the first surgery, they returm aprox 8 weeks later and implant the sites that were avoided on the first go. This is because if you expanded and placed an implant for adjacient teeth, you WILL break the buccal plate. So you have to give the bone a chance to recover. If you are serious, check with Tatum Surgical at 1-888-360-5550.

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