Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who have narrow alveolar bone ridges (2.5–4 mm). After marking the implant sites with a pilot drill, we used a piezoelectric surgery tip to cut the alveolar crest to the depth of the planned dental implant. We then sequentially used Versah Drills, accompanied by extensive irrigation using cooled, sterile normal saline, and finally inserted the implant into the subcrestal level. Results: This study revealed a significant difference in alveolar ridge width immediately after the procedure, and the significant change in the mandible was slightly higher than that in the maxillary arch. However, all implants in both jaws achieved successful osseointegration. Conclusions: The alveolar ridge width changed a lot more in the mandible than in the maxillary arch after the procedure. These two strategies work well together to properly and simply expand severely atrophied alveolar ridges without affecting bone healing or the osseointegration process.
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