Modified ridge splitting technique using conical space maintainers for delayed implant placement in highly atrophic maxillae.

Background: A low-morbidity surgical technique is described for the horizontal augmentation of highly atrophic alveolar ridges in which first surgical step implant placement is contraindicated. The aim of this case report was to present an alternative treatment for the rehabilitation of the atrophic maxilla. Methods: The technique involves a crestal corticotomy with transverse expansion of the vestibular and lingual cortical layers, followed by the placement of threaded titanium space maintainers between the expanded bone tables. Results: The resulting surgically created biological space within the residual socket is completely filled with blood of marrow origin and great osteogenic potential. Due to the preserving effect of the titanium maintainers, we avoid partial collapse of the ridge widening initially obtained, which tends to occur to one degree or other as a consequen- ce of reabsorption during the physiological tissue repair process. Conclusions: This type of bone regeneration requires no autologous bone harvesting from other intra- or extraoral donor zones, thereby avoiding the increased morbidity associated with such procedures. It appears that alveolar ridge augmentation through corticotomy and threaded space maintainers may be a viable treatment approach for the implants placement in the severely atrophied maxilla