A Comparative Study of AI-Powered/Computer-Guided Versus Conventional Linear Micro-Perforation Split Approach for Treatment of Horizontal Mandibular Ridge Atrophy (A Randomized Clinical Trial)
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Kafrelsheikh University
- Enrollment
- 22
- Locations
- 1
- Primary Endpoint
- ridge width
Study Overview
Brief Summary
The traditional ridge split technique might be performed simultaneously with implant placement, resulting in a shortened treatment time. However, this approach has the potential for serious complications, including buccal bone fracture, prolonged pain or paresthesia, and loss of bone height. Linear Micro-Perforation Osteotomy (LMPO) has emerged as a less invasive alternative, promoting natural bone expansion through controlled micro-perforations in the cortical bone, allowing for ridge widening without extensive grafting. However, the precision required for LMPO can be difficult to achieve manually, especially in anatomically complex or narrow ridge areas, leading to variability in outcomes and potential risks such as bone fractures or inadequate expansion.Our study aims to evaluate the efficacy, clinical, and radiological outcomes of the flapless AI-powered/computer-guided LMPO ridge split/expansion technique compared to the traditional LMPO ridge split/expansion method for lateral ridge reconstruction of mandibular horizontal ridge deficiencies.
Detailed Description
In contemporary dentistry, the aim is to replace missing teeth with prosthetics or to remove diseased teeth from the patient and return them to normal in terms of shape, function, comfort, appearance, speech, and health. Why implant dentistry is different is the capacity to fulfill this objective despite atrophy, illness, or harm to the stomatognathic apparatus.
Implant-based dental rehabilitation of partly or completely edentulous areas has become a frequent procedure with consistent long-term outcomes in recent decades. Nevertheless, alveolar ridges are frequently impaired with horizontal inadequacy as a result of bone resorption, which has an impact on implant application.
The resorption of alveolar bone is a common sequelae of tooth loss and presents a clinical problem for implant placement. Implants must be placed with at least 1 mm of bone on the buccal and lingual aspects to maintain crestal bone levels.
Narrow edentulous ridges less than 5 mm wide present a challenge to the clinician for implant placement. Hence, lateral bone augmentation procedures are necessary to overcome maxillary and mandibular bone deficiencies. These procedures involve the use of bone augmentation, such as guided bone regeneration (GBR), bone block (autogenous or non-autogenous), and conventional onlay/inlay graft. Those procedures have many drawbacks such as longer healing time (6-9 months) for adequate bone regeneration before implant placement, the possibility of membrane exposure, an increased risk of infection, high cost, and rapid graft resorption; thus leading to inadequate bone regeneration or loss of the newly formed bone.
Based on previous knowledge, ridge split/expansion was introduced as an alternative to treat the width insufficiency of alveolar ridges with specific indications. The basic procedure includes a sagittal osteotomy in the center of the edentulous ridge, where the two cortical plates are expanded to increase the width and thereby simultaneous implant insertion with an appropriate diameter could be achieved.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 40 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Patients presenting with narrow alveolar ridge that requires dental implantation.
- •Minimum bone width of 3 mm
- •Ridge width of not less than 3 mm in CBCT image
- •Minimum bone height of 10 mm
- •Proper inter-occlusal space
- •Perioperative cone beam CT scan image of the atrophic ridge
Exclusion Criteria
- •• Uncontrolled diabetes.
- •Heavy smokers.
- •Current chemotherapy or radiotherapy.
- •Alcohol or drug abuse.
- •Pregnant women.
- •Active infection.
- •Inter-occlusal space not less than 7-8 mm.
Arms & Interventions
study group I
ridge split and expansion with free-hand linear micro perforation osteotomy approach with simultaneous implant placement
Intervention: Free-hand linear micro perforation osteotomy and ridge splitting (Procedure)
study group II
ridge split and expansion with AI-assisted/computer-guided (linear micro perforation osteotomy approach with simultaneous implant placement)
Intervention: AI-assisted/computer-guided linear micro perforation osteotomy and ridge splitting (Procedure)
Outcomes
Primary Outcomes
ridge width
Time Frame: 12-months
The width of the alveolar bone will be measured again using CBCT
Secondary Outcomes
No secondary outcomes reported
Investigators
Walid Elamrousy
Assistant Professor of periodontology
Kafrelsheikh University