Time for fractured buccal bone resorption during ridge split?

Not sure what you mean, if it is the green stick fracture of the buccal plate with grafting in between 6-8weeks a non mobile fracture but 12-16 weeks for remodeling and implant placement. The cortical bone should not resorb but remodel. Now if you are talking about a thin sequestra which might not heal but exfoliate then anywhere from 6-12 weeks.

I mean if a buccal plate which was thick around 1.5mm fractured was mobile but did not fell down (had a attachment somewhere. A full thickness flap was raised, while splitting the buccal bone fractured, it was thick. I approximated the edges, added a graft (but not enough I believe) and covered with the membrane and approximated without the screw. the implant was placed. the buccal plate was not under any pressure after implant placement. I am worried will it get resorbed. I had submerged the implant.

Dr. CRS sir can I have your email please.

I'll find out how to do that. At surgery I would have placed a bicortical screw to draw the cortices together since the implant will displace them. However if it is a small enough it will work its way thru. You may get a fibrous union if it is mobile. If it is along the cortex it may not affect the implant I 'd have to see a film or photo to be sure.

Difficult one ridge splitting as can be a bit of a lottery , best to keep the periosteum attached to lessen the sequestration issue . When I am expanding a ridge and the plate fractures I generally remove the fractured bone and bin it , grafting with a particulate ( In my case synthetic which sets ) . Hence splitting in the esthetic zone must be treated with caution. Peter

Peter Why would you bin the bone? Could you not particulate it with a grinder and use it?

first it is different if it is upper or lower case. fracture happen more in single case implant , and I wonder how you was able to put the implant while the buccal plate is fracture, the onlyway is that the apical part is still attached so you can get primary stability.so I think the question is aboiut implant primary stability stability and osseointegration

Hi George , mainly because it is dead once fractured off and hence the bodies role is to remove it through sequestration and osteoclastic activity . Initially I used bone chips etc but stopped about 10 years ago as results were better , faster without . We have done a many cores for histo and micro CT . Most particulates and some more than others possess a negative Zeta potential which attracts bone proteins , Osteopontin , Calcin etc , which in turn attract increased mesenchymal cells ( Osteoblasts ) to the site thus up-regulating the host response to regeneration ( see research by Hunt and Cooper ) . Thus introducing an initial osteoclastic phase my not be beneficial , as to the old dogma " the bone has good stuff in it " , well that is all in the blood . The concepts are as old , just forgotten possibly by marketing . Yes Dr Hossam the upper , maxillary arch I feel is more forgiving and flexible in expansion and splitting cases Regards Peter

Hi Peter but that would mean things like onlay grafts with autogenous wouldnt work so well. Do you feel you get better results with fortoss?

Hi George , Agreed in the hands of skilled surgeons Khoury etc ( and many on here , BV etc ) they can do but we feel there may be benefits for the patients , reduced morbidity faster regeneration etc . Many different ways work just another idea and thought trying to work with the healing process We seem to get great results hence work this way now although do not use Fortoss anymore . Regards Peter

Hi Martin , it is a good material , just been pushing the concept a bit more and have been getting improved results . But e-mail me as do not really feel this site is for marketing . Regards Peter

The premise of the ridge split, is to keep your segments alive. These are vascularized bone" flaps" essentially. The procedure originated from the principles of the le fort one osteotomy, or any other orthognathic procedure. This is a technique sensitive procedure and has some very limited applications. Please refrain from attempting this procedure until you have seen several and had some Formal training. A lot if damage can be created with the poor split. Bvinci