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Teeth loss in the posterior mandible initiates residual ridge resorption especially in vertical direction, this causes difficulty in implant placement so ridge augmentation must be done either simultaneous with implant placement or in a staged approach Aim: To evaluate the effect of bone ring technique versus split bone block technique with simultaneous implant clinically on primary and secondary
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bone ring technique | Experimental |
| |
| Split bone block technique | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bone Ring | Other | Patients in this group will be treated with the bone ring technique. An implant drill will be used next to prepare central osteotomies corresponding to the final implant diameter to be placed in the center of the disc converting it to a "bone ring". |
| Measure | Description | Time Frame |
|---|---|---|
| Change in implant stability | Implant stability will be recorded immediately after placement (1ry stability) and after 6 months (2ry stability ) by using osstell device. The result is presented in form of ISQ value from 1to 100, the higher the ISQ the higher the stability of implant( | Immediate and 6 months |
| Change in pain scores | Pain will be assessed for 7 days postoperatively using 10-point visual analouge scale (VAS) (0-1=None, 2-4=mild, 5-7=moderate, 8-10=severe ). | up to 7 days |
| Change in marginal bone level | At buccal, lingual, mesial, and distal sites will be evaluated radiographically from the shoulder of the implant to the alveolar crest. | 6 and 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in bone density | Will be measured at 6 points around the implant and a mean value will be calculated using CBCT | 6 months |
| Change in edema | Measured as follows: No inflammation = none. Intra oral swelling confined to the surgical field = mild. Extra oral swelling in the surgical zone =moderate. Extra oral swelling spreading beyond the surgical zone =intense. |
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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 |
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| Split Bone block | Other | Patients of this group will be treated with split bone block with simultaneous implant technique. The bone shell will be split into two bone shells each 1 ~ 2 mm in thickness using a disc. |
|
| up to 7 days |