by James Dawson (New Zealand), Jonathan Leichter

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Objectives: Understanding the bony anatomy at the site of implant placement is essential for implant success. Computed tomography (CT) is generally considered the gold standard for assessing bone morphology, however there are situations in which it is not practical. The ridge-mapping technique has been advocated as a convenient way to assess site suitability for implant placement, and was used in this patient to plan a single dental implant. Methods: An unrestorable maxillary lateral incisor tooth was extracted and the socket was preserved using Bio-Oss[tm] and a Bio-Gide[tm] membrane. This healed undisturbed for 2 months, then alginate impressions were taken and plaster study models fabricated. A mapping stent was fabricated from the plaster model using rigid acrylic material to ensure stabilisation[stability?]. The stent overlapped the buccal and palatal mucosal tissue. Holes were drilled in the stent at 2mm, 4mm, 6mm and 8mm from the alveolar crest, allowing a size 20 endodontic file to pass through. At each pre-drilled site, the depth was measured from the acrylic stent surface to the bone. The cast was then sectioned and measurements were transferred to the cast to provide an outline of the underlying bone. Following clinical assessment and outline measures, a bone level Strauman implant of 3.3-mm diameter and 12-mm length (SLActive was planned. Local anaesthesia was administered before making a slightly palatal incision and reflecting a full-thickness mucoperiosteal flap. The alveolar ridge was measured using a caliper. The osteotomy was prepared using standard drills and the implant was placed 3mm from the cervical margin of the proposed restoration. Results: Ridge mapping and direct measurement with calipers yielded similar dimensions of the alveolar crest. Conclusion: This report demonstrated that ridge mapping using endodontic files and a model-based template gives an accurate representation of the underlying alveolar bone. This technique may be suitable when standard radiographic techniques are not possible.
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