The protocol outlines a randomized clinical trial comparing two surgical techniques for horizontal ridge augmentation in the anterior mandible:
Computer-Guided Autogenous Cortical Shell Technique (using a patient-specific guide for precise placement).
Free-Hand Autogenous Cortical Shell Technique (traditional approach without a guiding template).
Key Points:
The study aims to determine which method provides better accuracy and bone volume stability.
Cone Beam CT scans (CBCT) will assess horizontal bone gain preoperatively and six months postoperatively.
The trial is conducted at Cairo University's Faculty of Dentistry. Participants: Patients with pure horizontal bone loss in the anterior mandible.
Outcomes:
Primary: Bone width gain in millimeters. Secondary: Accuracy of augmentation and surgical time.
Methodology:
The study group will use computer-designed surgical osteotomy guides to harvest and place bone grafts with improved precision.
The control group will rely on the conventional free-hand approach. Both groups will undergo bone grafting using autogenous cortical bone shells.
Data Collection \& Analysis:
Participants will be randomized and blinded. Data will be analyzed using statistical methods to compare effectiveness.
• Anterior mandible with horizontal deficient alveolar ridge that is from 2 to 4 mm measured from the crest of the alveolar ridge buccolingually.
Class IV and V according to Cawood and Howell classification.
No sex predilection.
Patients free from any systemic conditions and bone metabolism diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing.
• Intra-bony lesions (e.g. cysts) or infections (e.g. abscess) that may retard the osteotomy healing.
General contraindications to implant surgery.
Subjected to irradiation in the head and neck area less than 1 year before implantation.
Untreated periodontitis.