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

Guided bone regeneration (GBR) is a reliable method to augment insufficient bone volume for implant placement. Membrane exposure is a major complication of GBR especially when using non-resorbable membranes and is avoided by tension free primary closure. Classically Periosteal Releasing Incision (PI) is performed to advance the flap. Double-flap incision (DF) technique was introduced lately to overcome some of the complications of PI and attain superior tension free closure. The aim of this clinical trial is to compare DF incision to PI in terms of flap advancement, postoperative pain & swelling, mesh exposure and bone quality and quantity in guided bone regeneration using titanium mesh. Materials & Methods: Two groups of participants,seven patients in each group, undergoing GBR using Ti-Mesh & Xenograft. The flap advancement in each group was achieved using a different flap advancement technique:Test group: DF, A full-thickness crestal incision was made over the edentulous ridge & one partial-thickness vertical incision was made on the buccal side. A partial-thickness flap was raised first to separate the mucosal layer from the overlying periosteum. Afterwards, the periosteal layer was elevated using periosteal elevator to expose the underlying alveolar process. After mesh and bone application, the periosteal flap was sutured first securing the regenerative site then the mucosal flap is sutured above

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