Két lépésben, piezoelektromos eljárással végzett csontrepesztés a mandibula distalis foghiányának implantátummal történő rekonstrukciójához

Reconstruction of posterior edentulous mandible with dental implants requires residual ridge width of 5,5 mm or more. Toachieve such crestal dimension two-stage ridge splitting technique has been used at our patients (n=4) with piezoelectricbone surgery. The first stage consisted of full mucoperiosteal flap elevation to expose the vestibular aspect of the posteriormandible. Two horizontal (crestal and apical) and two vertical corticotomies were created, than the mucoperiostealflap was reapproximated. After 35 days of healing period using crestal incision lingually full-thickness flap, vestibularlypartial-thickness flap was elevated with intact periosteum on the buccal bone plate. In order to separate and lateralizethe vestibular cortical plate, the crestal cut was refreshed and with bone expanders widened until a gap of 4-5 mm wasestablished. Implants were inserted conventionally and followed by tension free soft tissue closure. After 5-6 monthselapsed, periapical radiographs depicted bone loss of maximum 1,0-1,5 mm around the neck of the implants. At the exposureno implant mobility was observed. Prosthetic loading with final crowns and fixed partial prostheses was successfulin all cases, no more bone resorption was registered during the 6 month follow-up. Nevertheless, bone graft applicationseems to be advisable.