Maxillary Horizontal Alveolar Ridge Augmentation Using Computer Guided Ridge Splitting with Simultaneous Implant Placement Versus Conventional Technique: A Randomized Clinical Trial

Background: Ridge splitting technique is considered one of the successful horizontal bone augmentation procedures especially for the maxillary bone, the aim of this study was to compare marginal bone loss using a novel ridge splitting protocol versus the conventional technique.

Material & Methods: This was a randomized clinical trial including 20 patients who were randomly assigned to ridge splitting with simultaneous implant placement at the anterior maxillary aesthetic zone (10 patients, 29 dental implant) using patient specific guides (PSGs) or conventional technique (10 patients, 29 dental implant). In the control group free hand ridge splitting was done, while in the study group all the splitting and drilling procedures were done through specific slits and sleeves at the patient specific guides. Radiographic Assessment included measurements of linear changes in the vertical dimensions of the labial plate of bone on cross sectional cuts of computed tomography (CBCT) using mimics software.

Results: Wound healing was uneventful for all the patients except one patient in the control group that showed bad split and another showed buccal fenestration. The study group showed lower bone loss (1.38 ± 0.61 mm) compared to the control group (2.42 ± 0.63 mm), with statistical significance difference (P value = 0.001). The loss percentage also was higher in the study group (10.99 ± 4.76%) compared to the control group (19.12 ± 4.53%), and there was statistical significance difference between the two groups (P value = 0.001).

Conclusion: Ridge splitting using PSGs appear to be efficient and promising than the free hand technique.