[Alveolar ridge augmentation with cortical osteotomies for dental implantation]

Cortical osteotomies allow alveolar ridge augmentation so as to place dental implants of adequate size, most often in one step. This technique is reliable and allows long-lasting prosthetic restoration, without need for a graft-harvesting site. We report an expansion technique, which combines various cortical alveolar osteotomies. It allows guiding bone fractures away from the implant site during the expansion procedure. The possibility of implant placement is enlarged because exposure risks for implants are limited. The technique also preserves cortical bone structure and resistance, while allowing a larger bone augmentation movement. The diameter, axis, and crestal emergence position are optimized, thus improving the biomechanical resistance of implant restoration. A better implant position and restoration of bone anatomy and volume, supporting the gingival alveolar mucosa, improve the esthetic and prosthetic result. This technique can be used if the ridge is very narrow with limited bone elasticity. We present the various osteotomies and basic surgical steps for transversal and even vertical alveolar ridge augmentation, as well as possible modifications and clinical results.