two groups of patients both have alveolar bone deficiency in anterior maxilla, one group will be subjected to khoury bone augmentation with conventional flap the other with vestibular shifted flap
The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization. * Full thickness Vestibular flap and 2 horizontal releasing incision are made (Key Concept: The vestibular shifted flap provides additional flap length by translating vestibular mucosa coronally while preserving keratinized tissue and blood supply) in a group and conventional flap in the other group * Flap elevation: Full thickness flap in the Donor site * Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested. * Blocks are carefully shaped into flat "plates." * The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension * The space between the host bone and the fixed cortical plates is filled with bone particles. * Tension free bilayered suturing
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
24
The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization. * Full thickness Vestibular flap and 2 horizontal releasing incision are made (Key Concept: The vestibular shifted flap provides additional flap length by translating vestibular mucosa coronally while preserving keratinized tissue and blood supply) * Flap elevation: Full thickness flap in the Donor site * Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested. * Blocks are carefully shaped into flat "plates." * The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension . • The space between the host bone and the fixed cortical plates is filled with bone particles. * Tension free bilayered suturing.
The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization. * Full thickness conventional flap and 2 horizontal releasing incision are made * Flap elevation Full thickness flap in the Donor site * Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested. * Blocks are carefully shaped into flat "plates." * The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension. * The space between the host bone and the fixed cortical plates is filled with bone particles. * Tension free bilayered suturing
faculty of oral and dental medicine ,Cairo university
Cairo, Giza Governorate, Egypt
Horizontal Bone Gain Assessed in millimeters by Cone-Beam Computed Tomography (CBCT)
Horizontal bone gain will be evaluated using cone-beam computed tomography (CBCT). Alveolar ridge width will be measured in millimeters (mm) at standardized reference points before the augmentation procedure and at 6 months postoperatively. The outcome will be calculated as the change in ridge width (mm) from baseline to follow-up.
Time frame: 6 months
Width of Keratinized Tissue Assessed by Periodontal Probe
The width of keratinized tissue will be measured clinically using a calibrated periodontal probe and recorded in millimeters (mm) at baseline and 6 months postoperatively. The outcome will be calculated as the change in keratinized tissue width from baseline to follow-up.
Time frame: 6 months
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