How to Handle Narrow Ridge in Guided Surgery

Guided surgery is the great equalizer as it effectively allows complex implant procedures to be as predictable and stress-free as simple implant placement.

Whether you are an experienced practitioner or in the early stages of practice, 3Sixty and guided implant surgery allow the clinician to carefully analyze the patient’s anatomical condition, occlusal scheme and bone morphology when pre-planning the implant surgery in Atomica Implant Planning Software.

Transferring the surgical plan to the patient with the use of 3Sixty precise 3D printed surgical guides permits the day of surgery to be as stress-free and predictable as possible.

With clinical decisions premade based on the pre-op x-ray, you have the reassurance to know that your implant will be placed in the best possible position and orientation for the patient.

The following case by Paul Mozer, DDS, MSc, DICOI, illustrates how this can be achieved clinically with outstanding treatment outcomes.

Clinical Case

Guided Surgery in Ultra-Narrow Bony Ridge

The patient presented with the diagnosis of external resorption in the lower anterior mandible. Without the predictability and ease of 3Sixty surgical guides, treatment planning for a narrow ridge would include the options of onlay block grafting with delayed implant placement and the disadvantages of a second surgical site, co-morbidities and technique-sensitive surgical procedures. The traditional prosthetic dental options of a lower partial denture and fixed bridge were alternatives that were less than desirable for the patient.

In this case, the ultranarrow platform Adin Touareg Closefit 2.75mm diameter implants were treatment planned for guided surgery with 3Sixty. Surgical guides were fabricated and the affected teeth were extracted as atraumatically as possible. Particulate bone grafts were placed with aPRF and iPRF and Adin Touareg Closefit 2.75mm implants were immediately placed with cover screws.

After 4 months of healing, the site was uncovered, healing abutments were placed for tissue contouring and an open tray impression was taken with Impregum. Three splinted screw-retained crowns were secured in place and the lingual screw accesses were covered with PTFE tape and resin.

What’s the difference in implant planning and surgical placement between a wide ridge and an ultra-thin ridge? Nothing! With 3Sixty surgical guides, implants in an ultra-narrow ridge are just as predictable to place in as a 5.0mm implant in a wide ridge. 

About the Author

Dr. Paul Mozer

Dr. Paul Mozer DDS, MSc, DICOI, FICOI graduated from Buffalo School of Dental Medicine where he received academic distinction and clinical commendations. He conducted oral cancer research at Roswell Park Cancer Institute and completed a residency at New York Medical College. Dr. Mozer has a Master of Science Degree in Oral Implantology from the University of Frankfurt Goethe Dental School, where he is now on faculty lecturing on guided implant surgery and serves as a Clinical Supervisor and advisor to Master Thesis candidates. He is also on the faculty of the AAID Maxicourse in Boston. He has conducted clinical research in 3D static and robotic guided implant surgery and is both a Diplomate and Fellow in International Congress of Oral Implantologists.

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