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Case Reports
. 2025 Apr 1;25(2):179-184.
doi: 10.4103/jips.jips_372_24. Epub 2025 Apr 11.

Precision implant placement: A novel approach using dynamic navigation system-guided alveolar ridge splitting

M Satyanarayana Raju  1 , Sruthima N V S Gottumukkala  2 , Koyya Sesha Sai Rakshitha  1 , M A K V Raju  3
Affiliations
Case Reports

Precision implant placement: A novel approach using dynamic navigation system-guided alveolar ridge splitting

M Satyanarayana Raju et al. J Indian Prosthodont Soc. .

Abstract

Conventional alveolar ridge splitting (ARS) technique involves a significant risk which may prove problematic. This case report presents the first documented application of dynamic navigation system (DNS)-guided ARS, demonstrating a precise approach to implant placement in a challenging anatomical scenario. A 37-year-old partially edentulous patient presented with missing mandibular posterior teeth. Clinical examination revealed a deficient alveolar ridge. Cone-beam computed tomography evaluation showed a Siebert's Class I resorbed ridge with 2.5 mm width and bone density ranging from 870 to 1040 Hounsfield Units in the #46 and #47 regions. Creating and designing three-dimensional virtual guide slits and implant planning using DNS were done in patient with insufficient bone width in the mandibular molar region. Piezoelectric ARS, osteotomy preparation with implant placement was done. 0.70 and 0.26 mm deviations at #46 and 0.50 and 0.01 mm deviations at #47 were observed at implant entry and implant apex, respectively. The angular deviations were optimal. ARS using real-time navigation appears to be an efficient and promising technique.

Keywords: Dental implant; dynamic navigation system; posterior mandible; real-time navigation; ridge split.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Missing mandibular second premolar and first molar with Siebert’s Class I ridge defect with horizontal ridge deficiency; (b) Preoperative cone-beam computed tomography evaluation
Figure 2
Figure 2
Piezosurgical mid-crestal ridge splitting using the dynamic navigation system
Figure 3
Figure 3
Piezosurgical vertical ridge splitting using the dynamic navigation system
Figure 4
Figure 4
Osteotomy preparation at planned position using the dynamic navigation system
Figure 5
Figure 5
Postsurgical accuracy assessment of implant irt 46
Figure 6
Figure 6
Postsurgical accuracy assessment of implant irt 47
Figure 7
Figure 7
(a) Implants loaded with screw-retained porcelain fused to metal crowns; (b) Radiographs showing well-integrated implants with no signs of peri-implant bone loss
See this image and copyright information in PMC

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