Planned Labial Plate Advancement with Simultaneous Single Implant Placement for Narrow Anterior Ridges Followed by Reentry Confirmation

This article reports on the efficacy of a technique involving expansion of edentulous ridges of less than 3 mm in width by means of a planned green stick fracture of the labial plate and simultaneous implant placement without the need for membranes. This retrospective case series includes long-term results from 21 patients with 36 sites and 37 implants with a mean follow-up of 4 years, 5 months from the date of restoration. Freeze-dried bone allograft was used in 22 sites (61%) to augment the ridge. Reentry at stage-two surgery confirmed the preservation of the displaced labial plate after implant integration. Three implants were removed prior to the planned uncovering because of incomplete healing of the overlying gingival tissue; therefore, the survival rate of the labial advancement was 92%. No implants failed after definitive prosthetic loading; therefore, the cumulative survival rate of loaded implants was 100%. No significant bone loss was detected at the final follow-up visit. Follow-up after loading ranged from 9 to 148 months. Advancement of the labial plate with simultaneous implant placement to gain horizontal ridge width dimension was shown to be a reliable and practical procedure for single-tooth sites where other grafting methods are often difficult.