Peri-implant alveolar bone loss with respect to bone quality after use of the osteotome technique: results of a retrospective study.

Knife-edge configurations or non space-maintaining defects of the alveolar ridge limit the indications for implant-prosthetic rehabilitation. If ridge expansion is required, bone splitting and bone spreading techniques may be applied. Summers introduced a modified approach for ridge expansion by osteotome technique. The principles of this nonablative implant bed preparation technique are lateral and apical bone relocation and condensation. The peri-implant alveolar bone loss after use of the osteotome technique was evaluated radiographically with respect to the bone quality in 22 patients with 22 implants. Differences between the alveolar crest and the implant shoulder in radiographs obtained immediately after implant insertion, after the end of unloaded healing period and after different periods of functional loading were calculated. The osteotome technique was used in bone quality classes 2 and 3, respectively, according to the Lekholm and Zarb classification. Two implants failed. Significant differences were found between the bone levels after implant insertion and at the end of the healing period as well as after functional loading (P = 0.028). The bone quality was significantly correlated (r = - 0.505; P = 0.023) with the change of the peri-implant marginal bone height level 6 months after the implant installation. The present data indicate the importance of bone quality evaluation before application of the osteotome technique.