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In both complete and partial tooth loss, the use of dental implants as artificial replacements for missing teeth is a well-established and effective treatment modality, leading to high patient satisfaction and improved quality of life (1).
Horizontal deficiencies of the alveolar ridge can hinder implant-supported rehabilitation due to insufficient bone volume to support implant dimensions, negatively affecting the final prosthetic outcome from both functional and esthetic perspectives (2).
The split-crest technique reduces treatment time, the number of required surgical procedures, and the risk of complications, making it more acceptable to patients. Additionally, it allows for dental implant placement during the same surgical procedure and eliminates the need for a donor site for graft harvesting (3).
In this study, patients with posterior tooth loss in a narrow mandibular ridge underwent dental implant rehabilitation following alveolar ridge splitting and expansion performed using osseodensification, piezosurgery, or a magnetic mallet.
The objective of this study is to compare ridge width gain following ridge splitting and expansion with simultaneous implant placement using osseodensification, piezosurgery, or a magnetic mallet in individuals with narrow mandibular alveolar ridges.
Thirty-nine patients will be randomly allocated into three groups. In Group 1, ridge splitting and expansion will be performed using piezosurgery and bone expanders, followed by simultaneous implant placement.
In Group 2, osseodensification burs will be used after ridge splitting, with simultaneous implant placement.
In Group 3, a magnetic mallet will be used after ridge splitting, with simultaneous implant placement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Osseodensification group: | Experimental | Ridge splitting and expansion were carried out by creating horizontal and vertical cuts with piezosurgery, followed by expansion of the alveolar ridge using osseodensification burs |
|
| Magnetic mallet group: | Experimental | Ridge splitting and expansion were performed using piezosurgery to create horizontal and vertical cuts, followed by chisels with a magnetic mallet to expand the ridge |
|
| Piezo-surgery group | Experimental | Ridge splitting and expansion were performed with piezosurgery inserts, followed by bone expanders |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Osseodensification | Procedure | Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion with osseodensification burs. Immediate implant placement will then be performed. |
| Measure | Description | Time Frame |
|---|---|---|
| The marginal bone loss | Changes in bone height following ridge splitting and expansion were assessed radiographically. Measurements were performed using cone beam computed tomography (CBCT) and periapical radiography | Assessments will be conducted 4 months after surgery and 6 months after functional loading. |
| The bone width gain radiographically | The extent of bony expansion represents the increase in alveolar ridge width in the buccolingual direction, as determined by radiographic assessment using CBCT. | At baseline, after surgery, 4 months after surgery, and 6 months after functional loading. |
| Measure | Description | Time Frame |
|---|---|---|
| Implant stability quotients (ISQ) | The Implant Stability Quotient (ISQ), measured using the MEGA device, provides a numerical assessment of both primary and secondary stability of dental implants. The scale ranges from 1 to 100, with higher values indicating greater stability and a higher likelihood of successful osseointegration. | Measurements will be taken at the time of surgery and again 4 months postoperatively. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ahmad Albassal, MSc | Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus | Principal Investigator |
| Munir Harfouch, MSc PhD | Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus | Study Director |
| Mazen Zenati, MSc PhD | Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Damascus | Damascus | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26800171 | Background | Pozzi A, Mura P. Immediate Loading of Conical Connection Implants: Up-to-2-Year Retrospective Clinical and Radiologic Study. Int J Oral Maxillofac Implants. 2016 Jan-Feb;31(1):142-52. doi: 10.11607/jomi.4061. | |
| 16968389 | Background | Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006 Oct;17 Suppl 2:136-59. doi: 10.1111/j.1600-0501.2006.01357.x. |
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| ID | Term |
|---|---|
| D007575 | Jaw, Edentulous |
| ID | Term |
|---|---|
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
| D009057 | Stomatognathic Diseases |
| D009066 | Mouth, Edentulous |
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| ID | Term |
|---|---|
| D059745 | Piezosurgery |
| ID | Term |
|---|---|
| D059708 | Ultrasonic Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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Blinding Participant and Statistician
| Magnetic mallet | Procedure | Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using chisels with a magnetic mallet. Immediate implant placement will then be performed. |
|
| Piezo-surgery | Procedure | Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using piezosurgery inserts and bone expanders. Immediate implant placement will then be performed. |
|
| Insertion Torque | The implant insertion torque was measured during implant placement using a dental implant torque wrench and recorded in Newton-centimeters (N·cm). | During the surgical procedure. |
| 25586966 | Background | Bassetti MA, Bassetti RG, Bosshardt DD. The alveolar ridge splitting/expansion technique: a systematic review. Clin Oral Implants Res. 2016 Mar;27(3):310-24. doi: 10.1111/clr.12537. Epub 2015 Jan 14. |
| 9586460 | Background | Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP, Belser UC, Lang NP. Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res. 1997 Jun;8(3):161-72. doi: 10.1034/j.1600-0501.1997.080302.x. |
| 11952734 | Background | Cochran DL, Buser D, ten Bruggenkate CM, Weingart D, Taylor TM, Bernard JP, Peters F, Simpson JP. The use of reduced healing times on ITI implants with a sandblasted and acid-etched (SLA) surface: early results from clinical trials on ITI SLA implants. Clin Oral Implants Res. 2002 Apr;13(2):144-53. doi: 10.1034/j.1600-0501.2002.130204.x. |
| D009059 |
| Mouth Diseases |
| D014076 | Tooth Diseases |