Screw spreading: technical considerations and case report.

The spreading system is an alternative technique to the Summers osteotome. The crest expansion technique is a less invasive procedure in which the facial wall expands after the medullary bone is compressed against the cortical wall. It improves the density of the maxillary bone, which allows for greater initial stability of implants. A specific screw instrument, the "spreader," achieved a controlled and standardized dilation of the bone horizontally. The use of spreaders to enhance the dental implant site is a highly predictable procedure.