Surgery case notes from Edward Shapiro, DDS
I did this surgery today. planned to extract #18 and #21, place immediate implant #21, expand ridge #19 and #20 using a newly learned technique called osseodensification, augment ridge and place implants #19,20 in one surgery. Alternatives would be ridge splitting(risk of buccal wall fracturing out) and ramus graft(invasive and would require waiting 6 months to place implants and a second surgical procedure). This osseodensification technique uses a series of osteotomy drills used in a sequence depending on the implants being placed. the 1.8mm pilot drill is used in forward motion at 1200 RPM. The next series of osseodensification drills are used in reverse at 1200 RPM. No bone comes out on drills. The bone is condensed and expanded laterally to increase the width of bone. In this case increased at crest from 3.7mm to 6.5mm allowing for placement of 3.75mm diameter implants at time of surgery. In maxilla should be able to double your starting width. I grafted on buccal for insurance to have a good 3mm of bone on buccal of implants and to graft defect #21. I learned this technique at the Dental XP Global Symposium earlier this month. Drill kit made by a company called Versah (developed by a periodontist).