Split crest osteotomy with low-frequency vibrating tools: a case report

Objectives. Split-crest osteotomies are used to increase the thickness of edentulous ridges during implant insertion. The purpose of this case report is to illustrate the advantages of performing these procedures with lowfrequency vibration, air-driven, non-piezoelectric handpieces, which are the most suitable instruments for carrying out thin osteotomies. Materials and methods. We report the case of a 68-year-old patient with edentulous ridge at sites 4.5, 4.6, and 4.7. The crest was thin and the masticatory mucosa reduced. First, the ridge was osteotomized with vibrating tools on a sonic, air-driven handpiece (Sonosurgery (R), Komet/Brasseler, Lemgo, Deutschland), and the vestibular cortical plate was distracted. Tapered implants were inserted during the same session, and the spaces between the implants were filled with equine collagen sponge. Results and conclusions. The procedure resulted in substantial augmentation of the horizontal thickness of the edentulous ridge and masticatory mucosa, which allowed satisfactory implant prosthetic rehabilitation of the posterior lower right sector. Thanks to the angles and reduced thickness (0.25 mm) of their cutting surfaces, the sonic air-driven tools allowed us to make thin, highly precise osteotomies.