RECONSTRUCTION OF THE ALVEOLAR RIDGE IN PERIODONTAL TISSUE PATHOLOGY UNDER COMPLEX ANATOMICAL CONDITIONS (CLINICAL CASE).

The optimal placement of dental implants in the jawbone tissue in cases of periodontal disease ensures conditions for the long-term success of osteointegration and the functioning of the prosthetic construction. However, the anatomical features of the mandible and maxilla often prevent dental implant surgeons from achieving the desired results after the placement of dental implants in cases of horizontal atrophy of the alveolar bone tissue [3,5-7]. Objective. To improve the treatment of patients with periodontal tissue pathology and horizontal alveolar ridge atrophy using an alveolar ridge split technique and to share our experience of applying this technique without bone augmentation. Materials and Methods. Preliminary examination was conducted using generally accepted subjective and objective examination methods. Targeted X-rays and computed tomography with 3D reconstruction were performed using the Morita Veraviewepas 3D Model X-550 (Japan). A 40-year-old female patient Z. presented to the Department of Therapeutic Stomatology, Periodontology, and FPGE Stomatology, complaining of the absence of tooth 24 and the damaged crown of tooth 25. Results and Discussion. In our study, we decided to apply our developed technique of gradual alveolar ridge split using a piezoelectric periotome in the affected area without using bone substitutes. We named this technique "stepwise splitting," using several sizes of spreader chisels (from larger to smaller sizes). The phosphorus-to-calcium ratio in the bone tissue preserves not only strength but also flexibility and elasticity, allowing the bone to act as a shock absorber while stretching the alveolar ridge transversely almost twice its size. This approach reduces stress loading during the osteointegration of dental implants under complex conditions. Conclusion. Modern research on the effectiveness and safety of dental implants under complex anatomical conditions associated with periodontal tissue pathology is impossible without the practical skills and experience of the dentist along with auxiliary diagnostic technologies. Therefore, new approaches have been introduced into clinical practice for the treatment of horizontal alveolar ridge atrophy of the mandible and maxilla using "stepwise" alveolar ridge splitting.