The alveolar ridge splitting/expansion technique: a systematic review

Area of Science:

• Dental implantology
• Periodontology
• Oral surgery

Background:

• Alveolar bone deficiency is a common challenge in dental implant placement.
• Alveolar ridge splitting/expansion technique (ARST) offers a potential solution for horizontal bone augmentation.
• Guided bone regeneration (GBR) is often used in conjunction with ARST.

Purpose of the Study:

• To systematically review clinical, radiological, and histological outcomes of ARST with or without GBR.
• Evaluate ARST as a one-stage alternative to traditional grafting procedures.

Main Methods:

• Systematic review of MEDLINE (PubMed) and EMBASE (OVID) databases, plus hand search.
• Inclusion of human and animal studies reporting simultaneous ARST with dental implants up to May 2014.
• Quality assessment using ARRIVE guidelines and Cochrane collaboration's tool.

Main Results:

• 18 human and 6 animal studies were included; no RCTs found.
• Reported implant survival and success rates were high (91.7-100% and 88.2-100%).
• Evidence suggests increased crestal bone loss, particularly at buccal sites, during healing and initial loading phases.

Conclusions:

• ARST is a functional one-stage alternative to two-stage horizontal grafting.
• Increased crestal bone loss at buccal sites should be anticipated.
• Adjunctive horizontal GBR may help preserve buccal bone dimensions.