Alveolar Ridge Split Technique With Simultaneous Implant Placement: A Clinical Case Series With One-Year Follow-Up

Ridge resorption following tooth loss may limit ideal three-dimensional implant placement. The alveolar ridge split technique (ARST) is used for horizontal ridge augmentation and may permit simultaneous implant placement in selected narrow ridges. This case series aimed to assess horizontal bone gain following ARST with simultaneous implant placement and evaluate short-term ridge stability one year after loading. Three systemically healthy patients presenting with maxillary horizontal bone width of less than 6 mm were included. All underwent ARST using piezosurgery and chisels with simultaneous implant placement, followed by xenogeneic bone grafting and coverage with a pericardium membrane stabilized using titanium pins. Second-stage surgery was performed four months postoperatively, and definitive crowns were delivered one month later. Cone beam computed tomography (CBCT) and clinical measurements of ridge width were obtained preoperatively, immediately postoperatively, at crown delivery, and one year after functional loading. All three cases healed uneventfully, and all implants remained in function at one year after loading. The mean radiographic horizontal bone gain was 3.83 mm (range, 2.9-4.8 mm), while the mean clinical gain was 4.16 mm. A minimum buccal bone thickness of 2 mm was maintained around all implants at the one-year follow-up. No implant loss, membrane exposure, or major postoperative complications were observed. Within the limitations of this three-patient case series and one-year follow-up, ARST with simultaneous implant placement and guided bone regeneration was feasible and associated with favorable short-term clinical and radiographic outcomes in carefully selected narrow maxillary ridges. The technique achieved horizontal ridge augmentation and maintenance of adequate buccal bone thickness at one year after loading in all cases. However, these findings should not be interpreted as evidence of broad treatment predictability, comparative effectiveness, or long-term stability. Larger prospective comparative studies with longer follow-up are needed to confirm these preliminary findings and refine case-selection criteria.