Patients with long span, narrow edentulous ridge in the posterior mandible underwent piezotomed ridge splitting and osseodensification with simultaneous implant placement.

This study is a single arm clinical trial. Patients of both genders, who are indicated for ridge splitting, were recruited from the outpatient clinic, Faculty of dentistry, Alexandria University.

The PICO question: "What is the effect of piezotomed ridge splitting and osseodensification on implant placement in narrow posterior mandibular ridges?"

Ethical approval for the study was obtained from the regional Ethical Review Board of the Faculty of Dentistry. All patients were informed about the procedure details, and each participant signed a written consent.

Ridge expansion was accomplished by piezotomed ridge splitting and osseodensification. Simultaneous implant placement was done in the same procedure.

Implant stability was assessed. Also, bone width gained and bone density were measured around the dental implants using cone beam computed tomography.

Inclusion Criteria:

• Patients with good oral hygiene
• Patients with long-span, narrow posterior edentulous mandibular area
• Age limit range [25 - 66 years]
• Patients who accept to participate in the study
• Minimum height 10mm from the crest of the ridge till the upper border of inferior alveolar canal
• Minimum ridge thickness = 3mm at the crestal region
• If the patient is diabetic, should be controlled.

Exclusion Criteria:

• Immunosuppressive/ autoimmune disease patients
• Patients with osteoporosis
• Lack of sufficient amount of keratinizing mucosa at the crest of the edentulous saddle
• Patients with bleeding disorder disease
• Ridge width less than 3 mm
• Smokers
• Patients having periodontal disease
• The presence of a pathological lesion in the area of ridge splitting