الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
For horizontal bone augmentation ridge splitting is considered one of the predictable treatment modalities. It is used for expansion of insufficient residual alveolar ridge width but has adequate vertical height. Also, it required some intervening cancellous bone present between buccal and lingual cortex and without bony undercuts to decrease risk of ridge fracture. During this technique for optimal implant initial stability, implants are placed apical to vertical bony cuts. The primary advantages of this technique are reduced treatment time, reduced tissue morbidity due to lack of the second surgical donor site and one stage augmentation procedure which are the main drawbacks of autogenous bone block graft.
In this study 16 Egyptian patients complaining from edentulous alveolar ridge with horizontal bone defect but had sufficient vertical bone height and soft tissue thickness were randomly selected. They were managed by alveolar ridge splitting technique to increase bucco-lingual bone width allowing simultaneous implant placement. For ridge splitting we used bone micro-saw for horizontal and vertical bony cuts followed by bone chisels and expanders.
Patients were divided into 2 groups with different treatment modality to fill intercortical gap. In group 1 we used PRF membrane to fill intercortical gap and covered by collagen membrane, while in group 2 xenogenic bone graft was used to fill intercortical gap then covered by collagen membrane. We monitored the changes and the effect of ridge splitting technique with simultaneous implant placement on the soft tissue thickness, horizontal bone width and the marginal bone loss in our studied groups.
Analysis of the clinical parameters including Plaque Index, Gingival Index and Soft Tissue Thickness in each studied group. There was a decrease in the plaque index postoperatively from that preoperatively with no significant difference between both groups. Gingival index of both groups shows a decrease postoperatively from that preoperatively with no significant difference between both groups.
Soft tissue thickness in group I preoperatively as well as 6 months and 9 months postoperatively showed a non-statistically significant decrease of the mean value measured 6 and 9 months postoperatively compared to that measured preoperatively. Also comparing that thickness 6 and 9 months postoperatively showed the same mean value. In group II showed a statistically significant decrease of the mean value of soft tissue thickness measured 6 and 9 months postoperatively compared to that measured preoperatively. Comparing that thickness 6 and 9 months postoperatively showed the same mean value. finally comparing soft tissue thickness between both groups preoperatively, 6 and 9 months postoperatively showed no statistical significance difference between both groups but with decrease in the soft tissue thickness in group II than in group I.
Regarding the bucco-lingual bone width of edentulous alveolar ridge measured by CBCT in group I, showed a statistically significant increase of the mean value of that width detected immediately, 6 and 9 months postoperatively compared to that measured preoperatively. On the other hand comparing that width detected immediately to that measured at 6 and 9 months showed a significant decrease of that value. Also comparing that width 6 and 9 months postoperatively showed nearly the same width value although still statistically significant.
Also, in group II showed a statistically significant increase of the mean value of bucco-lingual bone width detected immediately, 6 and 9 months postoperatively compared to that measured preoperatively. On the other hand comparing that width detected immediately to that after 6 and 9 months showed a significant decrease of that value. Also comparing that width 6 and 9 months postoperatively showed statistically significant decrease of the mean value. When comparing bucco-lingual bone width mean values between both groups preoperatively, immediately and 6 months postoperatively were non-significantly different. However, 9 months postoperatively the width was significantly lower in group II than group I.
Indicating that ARS was effective treatment modality for increasing ridge width and allow simultaneous implant placement but there was some decrease in that width gained after complete healing and implant loading especially in xenogenic bone graft group.
The marginal bone level in relation to the implant level measured by CBCT in group I immediately as well as 6 months and 9 months postoperatively showed a statistically significant decrease of the mean value of marginal bone level measured at 6 and 9 months postoperatively compared to that measured preoperatively. Also comparing that level 6 and 9 months postoperatively showed statistical significance decrease. In group II showed a statistically significant decrease of that value measured at 6 and 9 months postoperatively compared to that measured preoperatively. Also comparing that level 6 and 9 months postoperatively showed statistical significance decrease. The marginal bone level difference between both groups immediately and 6 months postoperatively is higher in group I than group II but without statistical significance. This difference up to 9 months was noted to be statistically significantly higher in group I than group II. The difference in marginal bone level between 6 and 9 months postoperatively, although decreased in both groups is still higher in group I than group II. Indicating that slight marginal bone resorption is a predictable outcome following ridge splitting procedure during first year of implant insertion.