Rehabilitating the edentulous posterior mandible via short implants and a split ridge piezoelectric horizontal expansion procedure was performed. The control group had an immediate  expansion and implant insertion protocol, while the test group had a staged procedure of splitting the ridge without expansion in the first intervention, then re-entry with a  crestal incision and lingual flap release for placement of implants after 4-6 weeks.
Periapical  and CBCT analysis were performed and pain and swelling scales were recorded by the patient.
The results of 17 patients and 33 placed implants showed no statistically significant difference between both groups in terms of crestal bone resorption (p=0.4436), while there was a statistical significant difference in favor of the test group for the buccal and lingual plates horizontal bone resorption (p=0.0022). Based on the current data, the staged approach (test) might be a safer intervention in terms of less site complications such as buccal plate fracture or loss with a more forgiving treatment plan re-adjustment in case of an occurring complication. Post-operative pain and swelling showed superior results in the test group.

Is it possible to restore the atrophied posterior mandible with ridge splitting and short implants? A six months post loading RCT of two different techniques utilizing piezoelectric bone cutters