Comparison of ridge split and expansion: A prospective study

Introduction: Bone resorption following tooth loss often compromises alveolar ridge width, complicating implant placement and requiring augmentation. Chronic edentulousness leads to further ridge resorption, especially in the buccolingual dimension. Techniques such as onlay grafts, guided bone regeneration, and distraction osteogenesis are commonly used but have limitations. Ridge splitting has become an effective alternative for horizontal augmentation, allowing simultaneous implant placement and reducing morbidity by avoiding secondary surgical sites. Various modifications aim to lower risks such as fractures and enhance outcomes. Aim: To compare the effectiveness of motorized ridge expansion and osteotome-based ridge splitting techniques for horizontal ridge augmentation in implant placement. Materials and Methods: In this prospective study, 34 patients were recruited, with 4 lost to follow-up. The remaining 30 were divided into two groups: Group I (motorized expansion using the ESSET kit) and Group II (ridge splitting with osteotomes). Evaluations included pain, trismus, swelling, bone width gain, crestal bone loss, keratinized mucosa, implant stability, and probing depth. Results: Motorized expansion proved less painful and more reliable for ridge width gain compared to osteotomes. The swelling was not significantly different between groups on the 3 rd postoperative day. Presence of keratinized mucosa improved implant stability and probing depth. Group I had no mobility at 6 months, while three patients in Group II showed mild mobility. Crestal bone loss was greater in the osteotome group. Conclusion: Ridge splitting is minimally invasive, cost-effective, and effective for horizontal augmentation in both jaws, with no complications like cortical plate fractures observed.