An intraoral crestal incision with/out vertical arms was performed on alveolar ridge using blade no.15. After flap reflection, patroning the defect to help guide the area to be grafted from the donor site. At the chin area (donor site) unicortical cuts will be made at least 5 mm inferior to root tips, 5 mm superior to inferior border of mandible and 5 mm away from the mental foramen. The graft was luxated and split into two bone shells each 1 ~ 2 mm in thickness using disc. The bone shells and the donor site were scrapped for autogenous graft particles. Decortication of the recipient site. The graft was stabilised into the recipient site using two or more self tapping titanium screws placed midway corono-apical in the bone shell following the ridge contour. The autogenous particles were packed into the space between the split bone block and the ridge. Collagen sponge was used to cover the donor site. After 4 months the site was approached for implant placement using crestal incision

It was assessed through a 10-point Visual Analogue Scale (VAS). The categories were as follows (0-1= None, 2-4= Mild, 5-7= Moderate, 8-10= Severe)

Implant stability was measured using Osstell. Osstell measures the resonance frequency which indicated the implant stability. It has a scale from 1 to 100 where:

• <60 is considered low stability.
• 60 ~ 69 is considered intermediate stability.
• ≥ 70 is considered high stability

This was measured on cone beam computed tomography (CBCT) by comparing pre- and post-operative bone width at specific levels around the implant.