Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Periodontology

Introduction: Rehabilitation of mandibular posterior edentulous ridges with diminished vertical and horizontal alveolar bone is a challenging task, either done by removable prosthesis, fixed bridges or implant supported prosthesis. Aim: To introduce a solution for patients suffering from such condition, with removable prosthesis being a distant uncomfortable solution for them. In compensation of the vertical alveolar bone loss short implants were utilised, while for the horizontal component two ridge splitting techniques were tested utilising the piezo-electric bone cutter. Materials and Methods: The first approach was a staged approach which was focused on maintaining the buccal plate's highest vascularity possible via maintaining the buccal flap attached to the expanding bone plate while it moves in a hypothesis that such act might decrease the high crestal and horizontal plate resorption, post-operative morbidity and related complications during the intervention that were noticed in the single stage splitting approach. Results and conclusion: both techniques were similar in terms of horizontal ridge expansion and implant success. No statistically significant difference was found between both groups in terms of crestal bone resorption and buccal and lingual plates horizontal bone resorption. the staged approach might be a safer intervention in terms of less site complications such as buccal plate fracture or loss with a more forgiving treatment plan re-adjustment in case of an occurring complication. Post-operative pain and swelling showed superior results in the staged approach than in the single stage approach

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