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In the study group:
Tubes of 9 ml of venous blood will be taken from the patient and will be placed in a centrifuge at 2500 rpm / min for 5 min.
At the end of the centrifugation, the blood in the tube will be separated into two compartments one yellow and one red.
The yellow part will be withdrawn with a syringe to be mixed with the grinded autogenous bone previously obtained from intra oral site.
Components will be mixed using a probe until the formation of a single homogeneous component, called the MPM (Mineralized Plasmatic Matrix).
In the control group:
Postoperative follow up in both groups:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interventional | Experimental | Patients will receive 2 gm of amoxicillin 1 hour before surgery. Mouthwash 0.12% chlorhexidine solution for 30 seconds immediately before surgery. Inferior alveolar nerve block and long buccal nerve anesthesia using articane HCl 4% with 1:100,000 adrenaline local anesthetic solution. Flap will be reflected in intraoral donor site to completely expose bone. Autogenous bone graft will be obtained and will be ground. MPM (Mineralized plasmatic matrix) will be prepared. Implant fixture/s will be inserted. Uncovered fixture threads and bone defect will be covered by MPM. Osstell will be used to measure fixture primary stability in ISQ units. Sutures will be placed. Sutures will be removed 7 days later. Immediate postoperative CBCT will be performed. Antibiotic (combination of 500mg amoxicillin and 125mg clavulanic acid) and analgesic and anti-inflammatory (Ibuprofen 600mg) will be prescribed. |
|
| Comparator | Active Comparator | Patients will receive 2 gm of amoxicillin 1 hour before surgery. Mouthwash 0.12% chlorhexidine solution for 30 seconds immediately before surgery. The patient will receive inferior alveolar nerve block and long buccal nerve anesthesia using articane HCl 4% with 1:100,000 adrenaline local anesthetic solution Flap will be reflected in intraoral donor site to completely expose bone. Autogenous bone graft will be obtained and will be ground. Implant fixture/s will be inserted. Uncovered fixture threads and bone defect will be covered by autogenous bone graft and covered by titanium membrane. Osstell instrument will be used to measure and record fixture primary stability in ISQ units. Sutures will be placed. Sutures will be removed 7 days later. Immediate postoperative CBCT will be performed. Antibiotic (combination of 500mg amoxicillin and 125mg clavulanic acid) and analgesic and anti-inflammatory (Ibuprofen 600mg) will be prescribed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mineralized plasmatic matrix for bone augmentation | Procedure | Vertical bone augmentation of defective posterior mandibular alveolar ridge using MPM (Mineralized Plasmatic Matrix) bone graft. |
| Measure | Description | Time Frame |
|---|---|---|
| Implant body stability in ISQ unit | Change from baseline implant body stability at 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Bone height in Cone beam CT | Change from baseline bone height at 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Patient satisfaction using questionnare | 9 months |
Inclusion Criteria:
Exclusion Criteria:
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| Autogenous bone for bone augmentation | Procedure | Vertical bone augmentation of defective posterior mandibular alveolar ridge using autogenous bone graft (gold standard) covered by titanium membrane. |
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