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Background: After tooth extraction changes of the shape of the alveolar bone follows a predictable pattern, which proves to be challenging in restoring its form and function, especially in the esthetic zone. Autogenous grafts remain the gold standard because of their predictability. The island osteoperiosteal flap (I-flap) is introduced as a modified alveolar split bone grafting technique used to gain width, height and modify the facial or buccal bone plate position.
Aim of the study: This study aims to evaluate in anterior atrophic maxillary ridge augmentation using guided unreflected island osteoperiosteal flap (I-Flap) approach with simultaneous implant placement and interpostional bone grafting in comparison to computer guided ridge splitting method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Computer guided island flap | Experimental |
| |
| Computer guided conventional ridge splitting | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Island osteoperiosteal flap | Procedure | Crestal incision using no. 15 blade on a bard parker no. 3. Two blind lateral vertical ostotomies at about 1.5 to 2 mm from the adjacent tooth roots to preserve subpapillary and root bone coverage. These cuts are to ensure the complete fracture of buccal plate while being attached to the overlying periosteum. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in pain scores | Pain (by Visual Analogous Scale): Score 0 - No pain. Scores 1 to 3 - Mild pain. Scores 3 to 7 - Moderate pain. scores 7 to 10 - severe pain. | 1 day, 3rd day and 1 week |
| Secondary implant stability | implant stability was measured using ostell device | 4 months |
| Change in bone level (bone gain) | Immediate post-operative CBCT (T1) will be done to measure the alveolar bone gain, to assess the proper implant positioning, and finally to measure the width of the out-fractured buccal plate and the amount of interpositional bone graft. Four months postoperatively CBCT (T2) will be done to measure amount of bone gain | Baseline and 4 months |
| Change in bone density | Bone density at implant body is measured by using computerized tomography values | baseline and 4 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Outpatient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Egypt | Alexandria | Azarita | 00203 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41350657 | Derived | Salem OAEH, Elmahlawy AS, Saber ME. Evaluation of 3-Dimensional accuracy of guided implant placement using guided osteoperiosteal flap versus guided ridge splitting for atrophic maxillary augmentation (a randomized clinical trial). BMC Oral Health. 2025 Dec 5;25(1):1905. doi: 10.1186/s12903-025-07364-6. |
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| Conventional ridge splitting | Procedure | Crestal incision and 2 vertical releasing incisions will be made using a no.15 blade mounted on a Bard Parker no.3. Then, a full mucoperiosteal flap reflection to expose bone. |
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