The monocortical window (MCW): a modified split-crest technique adopting ligature osteosynthesis

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Bone Augmentation Techniques

Background:

• Split-crest procedures are effective for alveolar ridge augmentation when bone height is preserved but thickness is reduced.
• Ultrasonic devices are commonly used, but challenges arise with stiff, type 1 corticalized mandibular bone, limiting elasticity and augmentation.
• Complete detachment of outer lamellae can occur during expansion or implant placement in such cases.

Observation:

• Stiff mandibular bone presents significant challenges for lateral augmentation during split-crest procedures.
• Maintaining primary stability for both the expanded bone segment and dental implants can be difficult.
• Existing techniques may not provide adequate stability in challenging bone types.

Findings:

• A novel steel-wire ligature osteosynthesis technique offers primary stability to the expanded cortical window and implants.
• This technique is simple, quick, safe, bone-saving, and cost-effective.
• It facilitates ridge expansion, bone regeneration, and implant positioning in a single procedure.

Implications:

• This technique provides a viable solution for split-crest bone augmentation in challenging mandibular bone types.
• It enhances the predictability and success rate of dental implant placement in augmented sites.
• The bone-saving and cost-effective nature of this method makes it broadly applicable.