Ridge Expansion...the following images are very graphical

This series of images shows a Ridge Expansion procedure. The instruments and implant in this particular case are somewhat different from more conventional ones, however the concept is still the same.

The image above to the left shows a direct view of the missing incisor. The blue tangential lines show the esthetic defect on the ridge. In this case we decided to place a special implant designed for ridge expansion procedures, as shown on the right.

The left and right images above show the instruments used to expand the ridge. No drills are used in this technique. These instruments are driven into the jaw ridge, one by one, starting with the smallest one in diameter, until the hole is big enough to place the implant. This will also expand the outer part of the ridge, by bulging it out.

		The left picture shows one of the expansion instruments after it has been driven into the bone.

Once the final expander is driven into the ridge, try-in pins are used to determine the correct angulation for the future abutment, onto which the tooth will be cemented.

After the try-in pins are verified, the implant is inserted and the tissues re-sutured. As you can see on the left, this procedure is minimally invasive. At the above right you can see the implant after two weeks of healing. Note the difference in ridge width when compared to the original ridge dimension.

Here you can see before and after x-rays, to the left and right, respectively.

These two images above show on a transverse-sectional CT Scan how much bone we gained by this procedure. On the left you can see the pre-surgery condition. A reference line drawn from the pulp chambers of the adjacent teeth (blue) and a perpendicular line at the future implant site out towards the ridge shows us approximately 1mm of bone. If we compare this value to the one on the right side, which shows the post-operative CT Scan, we have approximately 7mm from the reference line, so we gained approximately 6mm of bone width.

The above technique can sometimes be used instead of the Onlay Graft technique, which is in general a much more invasive procedure.