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The Role of Piezo-Surgical Ridge Split Technique in the Reconstruction of Ridge Deficiencies - Part 2 of 2

Description:
In this 2nd of a series, Dr. Dan Holtzclaw demonstrates the role of piezosurgical mediated ridge split technique in the reconstruction of ridge width deficiencies in order to facilitate more optimal placement of dental implants. A number of different variations exist regarding this technique. However, in this section, Dr. Holtzclaw discusses the role of piezoelectric hinge assisted ridge split (PHARS) technique in creating a hinged ridge split that is filled with particulate allograft and covered with a barrier membrane. Specific emphasis is placed on outlining the advantages and unique challenges of the PHARS technique.

Date Added:
7/4/2011

Author(s):

Dan Holtzclaw, DDS, MS Dan Holtzclaw, DDS, MS

Dr. Holtzclaw received his dental degree (Cum Laude) from the University of Texas Health Science Center at San Antonio. During a subsequent 12 year ...
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Online Videos / Surgery / Bone Grafting / The Role of Piezo-Surgical Ridge Split Technique in the Reconstruction of Ridge Deficiencies - Part 2 of 2




Questions & Comments
Juan Uribe Saldarriaga - (3/10/2016 2:49 PM)

Very nice presentation congratulations Dr Dan, I just want to know, what are you doing now when you need to gain height and what bone regeneration procedures in vertical case you do. Thanks

henry salama - (10/10/2015 9:27 AM)

Harry, since the idea is to "split" (not just cut through) the buccal cortical plate from the palatal/lingual bone plate, we would require an intervening layer of cancellous bone. Therefore, the minimum thickness that can be "split" is likely to be about 3mm, i.e. 1mm buccal, 1mm cancellous and 1mm palatal. Also, Harry, why not post images of the CT in question on the Forum. I'm sure you will get a great deal of feedback. Good luck.

Harry Albers - (10/9/2015 4:56 PM)

What is the minimum thickness of a ride to due a ridge split technique? Can I send you a cone beam of a case? Harry Albers

byron scott - (5/26/2014 12:16 PM)

Very informative & straightforward.

Eviatar Buchman - (10/24/2011 5:32 PM)

Thank you very much for your presentation. In a case of braking the buccal wall how do you recomand to fix it. Is there any video about it. second question, what if the risk to damage the inferior nerve?

E. Buchman

dentimp huang - (7/23/2011 2:11 PM)

Great answer ! Thank you , Dr.Holtzclaw.

dan holtzclaw - (7/19/2011 5:03 PM)

Thank you for the kind comments.

To answer everyone's questions:

1) I generally will not place implants simultaneously in the mandible. The bone here is very dense, especially with a resorbed ridge. That is why I employ the apical hinge cut. This allows me to lateralize the buccal plate more extensively. With this being said, however, it also makes the area less stable for simultaneous implant placement. In the maxilla, I generally have no problem with placing implants with a ridge split (circumstances permitting)

2) I have only used PRF and have not used PRGF. They both have their supporters. It is very fun to watch Chokroun and Anitua square off against one another. I have seen great cases from both sides.

3) I have found that the ridge heals just fine with a full thickness flap. I understand the concept for a split thickness flap, but have not found it to be necessary.

dan holtzclaw - (7/19/2011 4:58 PM)

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alessandro zussino - (7/12/2011 2:23 PM)

Thank you Dr. Holtzclaw for your very interesting lecture and for the elegant surgery I've seen. When I approach this tecnique I try to insert implants at the same time of the ridge splitting in order to save time to my patient and myself, and also considering that implants can work maintaining the space of the splitted ridge, and moreover reducing the amount of graft needed; what's your opinion about that? Also: what do you think about the tecniques that suggest a split flap incision (like the ERE tecnique of Bruschi and Scipioni)?
Thank you so much.

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