Accuracy Assessment of Chin Graft for Ridge Augmentation Using Tooth-supported Guide Versus Free Hand Technique

Accuracy Assessment of Symphyseal Onlay Bone Grafting for 3D Maxillary Ridge Augmentation Using Tooth-supported Patient-specific Surgical Guide Versus Free Hand Technique: A Randomized Controlled Trial

This study compares the accuracy of osteotomies positions using patient specific guides for onlay bone shells harvested from the chin then the graft positioning for 3D upper anterior ridge augmentation using patient-specific tooth-supported guide versus free hand technique

In this study the tooth-supported stereolithographic guiding template is proposed to allow accurate onlay grafting of labial and palatal mono-cortical shells simultaneously after harvesting using computer-designed patient-specific surgical osteotomy guide. This customized osteotomy guide should provide accurate harvesting of autogenous bone blocks from chin area which also provides suitable contour with the anterior ridge area. This computer assisted surgery is supposed to help in decreasing the operation time, thus decreasing the devascularization time to the bone graft. Thus, it helps for increased accuracy to increase three-dimensional bone gain and decrease morbidity of donor site while gaining the maximum available bone volume. Tooth-supported graft placement guide provides reproducible and convenient design without the need of high surgical skills as well.

Inclusion Criteria:

• • Anterior maxilla with horizontal deficient alveolar ridge that is from 2 to 4 mm measured from the crest of the alveolar ridge buccolingually, combined with vertical deficiency.

  • Patients free from any systemic conditions and bone metabolism diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing.
  • Both genders males and females will be included
  • Normal vertical dimension with normal inter-arch space

Exclusion Criteria:

• Intra-bony lesions (e.g. cysts) or infections (e.g. abscess) that may retard the osteotomy healing.
• General contraindications to implant surgery.
• Subjected to irradiation in the head and neck area less than 1 year before implantation.
• Untreated periodontitis.
• Poor oral hygiene and motivation.
• Uncontrolled diabetes.
• Pregnant or nursing females.
• Immunosuppressed or immunocompromised
• Heavy smokers
• Patients undergo medication interfere with bone healing