الفهرس 
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Abstract
Alveolar ridge defects result from the gradual remodeling and resorption processes that occur after a tooth is extracted. Presence of ridge defects affect the esthetic outcome of the final restoration. A variety of surgical techniques have been proposed to correct such ridge defects including bone or soft tissue augmentation procedures or a combination of both. The use of subepithelial connective tissue grafts remain the gold standard for soft tissue volume augmentation. Various materials have been tested as alternatives in different studies.
As the use fat grafting has been increasing in popularity for soft tissue volume augmentation in the field of plastic surgery, this study aimed at evaluating the use of fat grafting versus subepithelial connective tissue grafts for soft tissue volume augmentation in localized horizontal ridge defects.
A total of 20 patients having 26 localized horizontal ridge defects were recruited for the study from the patient pool at the dental clinics of the faculty of dentistry, Alexandria University. Ridge defects were divided into two parallel groups:
Test group: localized ridge defects were augmented using autologous fat grafting
Control group: localized ridge defects were augmented using conventional SCTG.
Clinical periodontal parameters at neighboring teeth were recorded and impressions were taken at baseline, 10 days, 1 month, 2 months, and 3 months follow up. Casts were optically scanned, digitized and analyzed for volumetric
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differences between baseline and each follow up time-point. Pain was assessed using VAS and analgesic consumption was reported during the first 10 postoperative days. Biopsies of the augmented sites were taken at the last follow up visit using a Tru-cut needle and subjected to histologic examination.
Results of this study showed that both treatment modalities were successful with a statistically significant difference between mean defect volumes at baseline and 3 months follow up in both groups. Mean volume gain at 10 days was 129.85 ± 32.4 mm³ for the test group and 177.54 ± 57.68 mm³ for the control group with a statistically significant difference favoring the control group. Similarly, a statistically significant greater volume gain in the control group was detected at 2 and 3 months follow up. The mean percent shrinkage between 1 month and 3 months follow up was 51.78 ± 39.42 %, 39.42 ± 18.52 % in the test and control groups, respectively. Clinical periodontal parameters were stable over time in both groups. However, the width of keratinized mucosa showed a minor tendency to decrease in the test group throughout the study period with a percent change of -7.71 ± 24.5% while in the control group the mean percent change was + 4.1 ± 46 % with no statistically significant difference between groups.
Histological results revealed higher vascularity in the test group along with the presence of newly formed collagen fibers scattered among masses of adipocytes. In the control group, dense fibrous collagen bundles could be seen with adequate vascularity.