Split-crest and immediate implant placement with ultra-sonic bone surgery: a 3-year life-table analysis with 230 treated sites

Ultra-sonic bone surgery (USBS) has been recently introduced as a novel osteotomic technique. This clinical study reports on the application of this new technique to perform ridge-split procedures. Over a period of 3.5 years, 57 patients underwent a split-crest procedure with the aim to place 230 implants, 78 in the mandible and 152 in the maxilla, in order to rehabilitate nine full arches, three hemi-arcades, 43 partial bridges and 24 single crowns. The initial ridge width varied between 1.5 and 5 mm, average was 3.2 mm. The final width of the ridge ranged from 4 to 9 mm, average was 6 mm. The split length varied between 4.5 and 40 mm, average was 15 mm. Inserted implants were 3.25-5 mm in diameter however most of them (82.4%) were standard implants of 3.75 mm; implant length was classically 10-13 mm. Two hundred and twenty-eight (99.1%) out of the 230 planned implants were placed, the two non-suitable sites were in the maxilla. In the mandible, the ridge augmentation procedure was drastically eased by performing a basal longitudinal discharge notch. At second stage surgery, eight implants failed to osseointegrate; the success rate for the placed implants was 96.5%. All implants have been loaded for at least 2 months and no implant was lost after loading. One hundred and eighty-one and 77 implants have been loaded for at least 6 and 12 months, respectively. The 3-year life-table analysis of loaded implants showed a cumulative survival rate of 100%. The split-crest procedure performed with USBS showed to be safe and comfortable.