The split crest technique and dental implants: a systematic review and meta-analysis

Area of Science:

• Oral surgery
• Periodontology
• Dental implantology

Background:

• The split crest technique is a surgical procedure used to augment bone width in the jaw.
• Understanding bone volume gain and the impact of surgical instruments is crucial for successful dental implant placement.

Purpose of the Study:

• To systematically review and quantify bone volume gain using the split crest technique.
• To evaluate the influence of conventional surgical instruments versus surgical ultrasound on the technique's performance.

Main Methods:

• A comprehensive electronic literature search was conducted across multiple databases.
• A meta-analysis of 27 selected studies (4115 implants in 1732 patients) was performed to assess bone gain and implant survival rates.
• Studies were categorized based on the surgical instruments used: conventional or ultrasound.

Main Results:

• The overall implant survival rate was 97%.
• Average bone gain was comparable between conventional instruments (3.61mm) and surgical ultrasound (3.69mm).
• Only two studies had a low risk of bias, highlighting methodological limitations in the existing literature.

Conclusions:

• The split crest technique is a promising and effective method for increasing bone width.
• Bone augmentation outcomes appear consistent regardless of whether conventional instruments or surgical ultrasound are employed.
• Limitations in study design and diversity of implants preclude definitive recommendations on optimal instruments or implant designs.