Management of Atrophic Maxillary Ridge Using the Split-Crest Technique Associated with Motorized Expansion: A Case Report

Abstract

The rehabilitation of anterior mandibular defects with severe horizontal bone loss remains clinically challenging, particularly in smokers, whose vascular and healing capacity is compromised. Autogenous chin block grafts remain the gold standard for alveolar ridge augmentation due to their superior osteogenic potential compared to biomaterials. This report describes a 44-year-old male smoker with long-standing loss of mandibular incisors (31, 32, 41, 42) and significant horizontal bone deficiency preventing implant placement. Two cortical chin blocks were harvested and fixed with 1.5-mm screws, with the remaining spaces filled with particulate autogenous bone. After a 90-day healing period, CBCT confirmed adequate horizontal augmentation, enabling guided placement of two 3.0 × 10-mm implants. Osseointegration was confirmed after 90 days, and the patient proceeded to the prosthetic phase. This case demonstrates that despite smoking, autogenous block grafting provided predictable bone augmentation and allowed safe implant placement.