10 patients having deficient anterior maxilla will be recruited and a preoperative CBCT will be done to evaluate the vertical and horizontal dimensions of the intended alveolar ridge. pre-operative manufacturing of the digital surgical guides performed for Harvesting of the chin cortical bone struts from the symphysial area in the donor site and for Placement of the grafted cortical bone struts and the implant in the recipient site. Intra operatively the donor site (Chin) will be prepared to harvest autogenous bone from the chin aided by the patient's prefabricated bone harvesting guide. The recipient site (Maxillary anterior defect) will be prepared to receive the chin grafts. Grafts will be screwed in position and implants will be screwed in its preparation until it gains primary stability from basal bone, using the prefabricated bone fixation-implant placement guide. Any gaps will be filled with autogenous bone particulates from the chin. A healing tie base Abutment will be screwed into the implant through the third cortex. Primary stability will be assessed using Osstell device. An immediate postoperative CBCT will be done and superimposed on the preoperative CBCT to measure accuracy of plan transfer to make sure the planning was followed accurately. Follow up after 6 months and CBCT will be done for bone formation and density assessment and implant exposure for implant stability measurement-using osstell and removal Healing abutment and consecutive prosthetic loading.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
fabrication of surgical guide to aid in chin bone harvesting and another guide to help for accurate placement and simultaneous placement in anterior maxillary defective area.
Faculty of Dentistry, Cairo University
Cairo, Egypt
RECRUITINGBone quality (change in bone density)
Serial CBCT scans measuring change in bone density in grey value
Time frame: T0 before surgery, T1 immediately after surgery, T2 after 6 month
Bone quantity (bone formation "height and width")
Serial CBCT scans (T0 before surgery, T1 immediately after surgery, T2 after 6 month) measuring bone quantity in mm
Time frame: T0 before surgery, T1 immediately after surgery, T2 after 6 month
Implant stability
measure primary stability immediately after implant placement and in the second surgery using Osstell device (ISQ value of 1-100)
Time frame: day of the surgery and at 6 month
Accuracy of Plan Transfer
Superimposition of preoperative digital plan and the immediate postoperative CBCT to assess the positional discrepancy of the graft between the digitally plan versus the actual postoperative position will be measured in millimeters three dimensionally (anteroposterior, vertical and lateral position).
Time frame: 1-3 days postoperatively
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