Split-Thickness Design In Ridge Augmentation During Implant Therapy

Ridge augmentation is frequently necessary before or during implant placement to address bone deficiencies. Successful augmentation depends on primary closure. Conventional flap passivation techniques, such as periosteal releasing incisions, partially compromise vascular supply and may increase postoperative morbidity. In a posterior mandibular case with buccal ridge collapse, split-thickness flap design was performed by sharp dissection of the mucoperiosteal flap into outer mucosal and inner periosteal layers to achieve sufficient flap advancement. Following implant placement and horizontal ridge augmentation, the periosteal and mucosal layer were sutured independently to ensure tension-free wound closure. Postoperative outcomes were favorable, with minimal discomfort, negligible swelling, and no instances of wound dehiscence or membrane exposure. The stable ridge augmentation and satisfactory function were maintain at the 12-month follow-up. The split-thickness design can be widely applied in both horizontal and vertical ridge augmentation: Minimal flap advancement - Split-thickness flap creates a periosteal pocket, often obviating the need for barrier membranes and optimizing cost-effectiveness. Extensive flap advancement - Split-thickness flap combined with vertical releasing incisions. Shallow vestibular depth, high frenum attachment, or inadequate keratinized tissue – The Partial-Split K-incision Flap technique. Maxillary posterior region - The Coronally Positioned Palatal Sliding Flap Passivation. Thin gingival biotype - precise periosteal separation for double flap. The split-thickness flap passivation technique in simultaneous ridge augmentation ensures adequate coronal flap advancement, protect vascular supply, promoting primary wound closure. This approach establishes a stable graft space while significantly minimizing postoperative complications, including swelling and pain.