Horizontal Alveolar Ridge Deficiency, Partial Edentulism
Conditions
Keywords
Dental Implant;, Horizontal Ridge Augmentation;, Alveolar Ridge Deficiency;, Guided Bone Regeneration;, Carrot Technique;, Maxillary Esthetic Zone
Brief summary
This randomized controlled clinical trial aims to compare the effectiveness of the Carrot Technique and Guided Bone Regeneration (GBR) for the management of horizontal alveolar ridge deficiency in patients requiring implant placement in the maxillary esthetic zone. Twenty patients will be randomly allocated into two equal groups. Clinical outcomes including implant stability and soft tissue healing, as well as radiographic outcomes including alveolar ridge width, bone density, and marginal bone loss, will be evaluated using clinical examinations and cone beam computed tomography (CBCT) during a 12-month follow-up period..
Detailed description
The Carrot Technique is a minimally invasive approach that utilizes an autogenous bone core harvested during implant osteotomy and repositioned to augment the deficient buccal ridge. This technique may reduce donor-site morbidity while providing sufficient horizontal bone augmentation. Guided Bone Regeneration remains one of the most widely used techniques for horizontal ridge reconstruction through the use of bone substitute materials and barrier membranes. This randomized controlled clinical trial will compare the clinical and radiographic outcomes of the Carrot Technique and GBR in patients presenting with horizontal ridge deficiency in the maxillary esthetic zone. Twenty patients requiring single-tooth implant rehabilitation will be randomly allocated into two equal groups. Group I will receive implant placement combined with the Carrot Technique, while Group II will receive implant placement combined with Guided Bone Regeneration. Clinical evaluations will include implant stability assessed by resonance frequency analysis, soft tissue healing using the Landry Healing Index, and peri-implant inflammation using the modified sulcus bleeding index. Radiographic evaluation will be performed using cone beam computed tomography immediately after surgery and at 6 and 12 months postoperatively to assess changes in alveolar ridge width, bone density, and marginal bone loss. The study aims to determine whether the Carrot Technique provides comparable or superior outcomes to GBR for horizontal ridge augmentation associated with implant placement.
Interventions
PROCEDURECarrot Technique
Implant placement with simultaneous horizontal ridge augmentation using an autogenous bone core harvested from the implant osteotomy site with a trephine drill and fixed buccally using osteosynthesis screws.
PROCEDUREGuided Bone Regeneration
Implant placement with simultaneous horizontal ridge augmentation using bone substitute material and a collagen membrane according to guided bone regeneration principles.
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
Participants will be randomly assigned to receive either the Carrot Technique or Guided Bone Regeneration (GBR) during implant placement for treatment of horizontal alveolar ridge deficiency in the maxillary esthetic zone.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18 to 45 years. Missing a single tooth in the maxillary esthetic zone requiring implant placement. Good oral hygiene and patient compliance. Medically free from systemic diseases that contraindicate implant surgery. Slight to moderate horizontal alveolar ridge deficiency with a minimum ridge width of 5 mm. Adequate vertical bone height for implant placement. Medium to hard bone quality (D2-D3 according to Misch classification). Absence of bruxism or other parafunctional habits.
Exclusion criteria
* Presence of local pathological lesions (e.g., cysts or tumors) at the planned surgical site. Poor bone quality (D4 bone). Pregnancy. Heavy smoking. Any medical condition contraindicating implant surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Alveolar Ridge Width | baseline and 12 Months | Horizontal alveolar ridge width measured using cone beam computed tomography (CBCT). Changes in ridge width will be calculated by comparing measurements obtained immediately after surgery and at follow-up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Marginal Bone Loss | 12 Months | Marginal bone loss measured radiographically using CBCT using the implant as a reference. |
| Soft Tissue Healing | 1 Week, 2 Weeks, and 1 Month | Soft tissue healing assessed using the Landry Healing Index. |
| Modified Sulcus Bleeding Index | 1 Month and 12 Months | Peri-implant soft tissue inflammation assessed using the Modified Sulcus Bleeding Index (mBI). |
| Bone Density | 12 Months | Buccal peri-implant bone density measured using CBCT and expressed in Hounsfield Units. |
| Implant Stability Quotient (ISQ) | At implant placement and 12 months | Implant stability assessed using resonance frequency analysis and expressed as Implant Stability Quotient (ISQ). |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORSarah A Elmaghraby
Faculty of Dentistry, Mansoura University, Mansoura, Egypt
Outcome results
None listed