Onlay Grafting V/S Ridge Split Technique For Managing Thin Ridges – A Surgeon's Dilemma

Abstract The use of dental implants in oral rehabilitation of partially and fully edentulous jaws have become a routine treatment modality with reliable long term results. Implant placement necessitates sufficient amount of width and depth of alveolar ridge. Common methods to restore bone deficiency include guided bone regeneration, ridge split and autogenous onlay bone grafts. Ridge split technique is performed to widen a narrow ridge to place adequate diameter implants. Onlay bone grafting is a procedure where a block of autogenous bone is secured at the bone defect area to regenerate bone at the host site. The purpose of this study is to compare the feasibility and outcome of ridge split technique vs onlay bone grafting in implant prosthetic rehabilitation of knife edge ridges. Objectives: To compare the post-operative pain and healing, intra-operative time, post- operative scarring crestal bone loss, using the above mentioned modalities. Methods: Ten patient with long term edentulous region with knife edge ridges requiring implant prosthetic rehabilitation were selected for the entire research. The samples were randomly distributed into ridge split group and onlay bone grafting group. Results: (1) Intraopertive time and complete treatment time required was significantly higher in onlay bone grafting group. (2) Distribution of level of pain is slightly higher in onlay bone grafting group. (3) Final bone width gained is higher in onlay bone grafting group. (4) Crestal bone loss was significantly higher in onlay bone grafting group than that in ridge split group. Interpretation & Conclusion: Bone resorption for onlay bone grafting technique was higher than for ridge split technique, but their implant survival rates were similar. Ridge splitting technique could shorten the treatment period, decrease postoperative pain and swelling and pain, eliminate the need for a second surgical site, and ease the patient cooperation to the surgery.