Maxillary Alveolar Reconstruction, Virtual Surgical Planning
Conditions
Brief summary
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.
Interventions
PROCEDUREIsland osteoperiosteal flap
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.
PROCEDUREConventional ridge splitting
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.
Sponsors
Hams Hamed Abdelrahman
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patient seeking replacement of a missed maxillary anterior tooth by a delayed dental implant procedure. * Residual bone height is (8-15) mm and (3-4) mm alveolar bone width. * Good oral hygiene.
Exclusion criteria
* Uncontrolled Diabetes. * Coagulation disorders. * Immunological disorders. * Previous radiation of the head and neck region. * Abnormal bone physiology. * Therapy with Bisphosphonates. * Heavy smokers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in pain scores | 1 day, 3rd day and 1 week | 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. |
| Secondary implant stability | 4 months | implant stability was measured using ostell device |
| Change in bone level (bone gain) | Baseline and 4 months | 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 |
| Change in bone density | baseline and 4 months | Bone density at implant body is measured by using computerized tomography values |
Countries
Egypt
Outcome results
None listed