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

This systematic review aimed to determine: (1) the expected bone volume gain with the split crest technique, and (2) how the use of surgical instruments affects the performance of this technique. An electronic search was performed in the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Embase, PubMed/MEDLINE, Scopus, and Web of Science databases. Twenty-seven articles met the selection criteria and were subjected to meta-analysis of bone gain and survival rate; 17 reported the use of conventional surgical instruments and nine the use of surgical ultrasound. A total of 4115 implants were installed in 1732 patients (average patient age 52 years). The overall implant survival rate was 97%. The average bone gain in studies that used conventional surgical instruments was 3.61mm, while this was 3.69mm in those that used ultrasound. Only two studies presented a low risk of bias. The greatest problems identified during the qualitative analysis were related to random selection of the population and the absence of statistical analysis. The split crest technique appears to be a promising and effective technique to gain bone width, regardless of the surgical instruments used. Considering the diversity of the studies and implant types, no definitive recommendations can be made, especially with regard to the best instruments and implant design to be used.

Immediate Loaded Implants in Split-Crest Procedure

BACKGROUND

The aim of this study was to assess survival rate of immediate loading implants placed after split-crest technique.

METHODS

Thirty-six patients were enrolled in the study. They underwent placement of 93 dental implants in edentulous region after split-crest ridge expansion procedure. Implants followed an immediate loading procedure. Crestal bone levels were measured at baseline, at temporary prosthesis placement, at 1 year, and at 2 years from implant placement.

RESULTS

For dental implants, a survival rate of 98.92% was reported at 2-year follow-up, with a mean value bone loss of -1.02 ± 0.48.

CONCLUSION

This study assessed immediate loading implant placement after split-crest procedure at 2-year follow-up.