Deficient Alveolar Ridges Research Articles

Computer guided versus freehand dental implant surgery: Randomized controlled clinical trial

ObjectiveThis study compares, in terms of rehabilitation and recovery, freehand implant placement using flapless or mini-flap procedures with the use of 3D implant design software and specialized surgical templates among patients who are partially or completely edentulous. A secondary aim is to propose an algorithm for predicting the accuracy of implant placement. Method.Patients with an alveolar height of at least 7 mm and an alveolar width of at least 4 mm were randomly assigned to two groups. Group I comprised ten patients who received computer-guided dental implant placement, while Group II comprised ten patients who received manual placements. A temporary prosthodontic was immediately inserted onto the implants, which was replaced by a permanent one after 4–6 months. ResultsThe study enrolled twenty patients. A blinded, independent assessor evaluated the outcome variables, which included implant failure, marginal bone loss, treatment duration, post-surgical pain and swelling, use of painkillers, surgical time, and patient satisfaction. Pain scores in Group II were significantly higher than those in Group I, but there were no other significant differences. All patients experienced pain after 2 days, but by 7 days, only two patients in Group I and four patients in Group II were still suffering, although this difference was not statistically significant. After 14 days, all patients were asymptomatic. ConclusionAlthough the freehand technique is straightforward for experienced surgeons, surgical guides enhance the accuracy of implant placement, particularly in a deficient alveolar ridge.

Linear bone gain and healing complication rate comparative outcomes following ridge augmentation with custom 3D printed titanium mesh vs Ti-reinforced dPTFE. A randomized clinical trial.

The aim of this randomized clinical trial was to compare the qualitative (linear alveolar ridge changes) and quantitative (healing complications) outcomes after guided bone regeneration (GBR) using a custom-made 3D printed titanium mesh versus titanium reinforced dense PTFE membrane for vertical and horizontal augmentation of deficient alveolar ridges.

Horizontal Ridge Augmentation Using Sticky Bone with Platelet-Rich Fibrin (PRF) in Anterior Maxilla Clinical and Histologic Evidence: A Case Report

Alveolar ridge deficiency is an unavoidable sequela of tooth extraction and poses major clinical challenges when reconstruction is anticipated. Various surgical approaches have been proposed to address horizontal defects, with autogenous bone grafting considered the current benchmark. However, alternative methods, utilizing tissue engineering principles and bone substitutes, offer reduced patient morbidity. This report presents an alternative case of severe horizontal bone defect augmentation in the anterior maxilla using sticky bone in conjunction with platelet-rich fibrin (PRF), and a Ti-reinforced membrane. Histologic evidence of sticky, deproteinized bovine bone material (DBBM) mixed with PRF without the use of autogenous bone is reported.

Lateral Alveolar Ridge Augmentation with Autogenous Tooth Roots and Staged Implant Placement-5-Year Follow-Up Case Series.

Background/Objectives: Alveolar bone augmentation before implant placement is a safe and effective treatment option for the reconstruction of a deficient alveolar ridge. According to recent research, permanent teeth have been used as bone graft materials, with studies confirming their clinical and histological results. This study aimed to evaluate the efficacy of alveolar ridge augmentation with autogenous tooth roots and staged implant placement, and peri-implant tissue stability in augmented sites. Methods: A total of 20 augmentations with autogenous tooth roots on mandibular alveolar ridges in 15 patients were performed. After 6 months, the ridge width (RWa) and ridge width gain (RWg) were measured. Titanium dental implants were placed in grafted sites and loaded 10 weeks after placement. Clinical parameters (bleeding on probing-BOP; probing depth-PD; mucosal recession-MR; and clinical attachment level-CAL) were assessed 2 months (T1), 3 years (T2), and 5 years (T3) after implant loading. Results: The mean RWa was 6.71 ± 0.74 mm, and the RWg was 3.15 ± 0.54 mm, respectively. No statistically significant differences were observed for clinical parameters (BOP, PD, MR, and CAL) among different time points (p > 0.05). Conclusions: Autogenous tooth roots represent a viable solution for alveolar ridge augmentation and implant placement, providing a stable environment for peri implant tissues.

Internal Allo-Cortical Tenting: A Modified Ridge Split Technique in Three-Dimensional Ridge Augmentation.

Three-dimensional (3D) alveolar ridge deficiencies necessitate horizontal and vertical bone reconstruction for optimal implant positioning. Despite several available techniques, achieving desired augmentation outcomes remains challenging. This case study aims to present a modified ridge split technique for bone reconstruction in horizontal and vertical dimensions. The proposed technique was used to reconstruct the horizontal and vertical ridge defect from removing a previously failed implant. This technique includes placing a cortical allograft plate as an internal tent in the split ridge. A portion of the plate was inserted into the ridge, while the other part was placed in the coronal of the vertical defect. Additional guided bone regeneration was performed around the tented plate on both the buccal and lingual sides. After 5 months, cone beam computerized tomography revealed sufficient bone formation in horizontal and vertical dimensions. Within the limitations of the present case study, internal cortical tenting would be a reliable method for 3D bone reconstruction in cases where the ridge split is feasible.

Double layer graft technique for horizontal alveolar ridge augmentation with staged implant placement: radiographic histological and implant stability analysis–a case report

IntroductionHorizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling.Case presentationA healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement.ConclusionDLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.

Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: a systematic review. Part II: animal trials.

Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but their clinical effectiveness remains undetermined. The aim of the current systematic review was to critically appraise evidence from animal studies regarding the effectiveness of BR grafts in alveolar ridge reconstruction and their variations under different surgical protocols. Electronic retrieval of six databases (MEDLINE, Embase, Cochrane Library, ScienceDirect, Web of Science, and Scopus) and citation search until 11 October 2023, for animal studies on bone augmentation employing BR grafts. The outcome variables were total bone area (BA), bone volume (BV), bone-implant contact (BIC), and histology. The protocol was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and prospectively registered with PROSPERO (CRD42023453949). Ten studies were included in the qualitative analysis according to the screening criteria. Two studies demonstrated favorable bone remodeling and osseointegration of the BR with both the implant and pristine bone. A comparative study between autogenous BRs and allogenic BRs reported a higher percentage of BA and BIC at 4 months of healing, but conflicting data were observed at 8 months. Another study indicated a significant advantage of autogenous BRs over bovine and biphasic ceramic BRs in terms of BA and BIC after 5 weeks. Three studies found that using collagen membranes did not significantly affect BA, BV, or BIC when used simultaneously with autogenous BRs during implant placement. Two studies evaluated one-stage and two-stage implant placement in conjunction with BR grafts, revealing similar levels of BA, BV, and BIC except for differences in total treatment time. Furthermore, one study found that the use of mucogingival junction incision and split-thickness flap significantly reduced the incidence of wound dehiscence compared with conventional incision and flap. Vertical bone augmentation surgery utilizing BR grafts with one-stage implant placement yielded histological and histomorphometric outcomes comparable to those achieved with two-stage implant placement or the additional application of collagen membrane.

Application of a Custom Two-Piece Zirconia Device for Multidimensional Ridge Augmentation in a Trauma Patient: A Case Report

Background: Due predominantly to anatomic factors, most maxillary anterior extraction sockets exhibit greater resorption of facial rather than palatal alveolar walls. However, traumatic episodes can result in physical damage to interproximal and palatal alveolar walls, leading to complex deficiencies that can be difficult to manage. The purpose of this report is to describe the use of a two-piece, site-specific zirconia device to augment the facial, crestal, and palatal aspects of a deficient maxillary anterior alveolar ridge. Methods: A 25-year-old male with history of facial trauma presented to the Department of Periodontics, Army Postgraduate Dental School, Fort Eisenhower, Georgia, requesting replacement of teeth #8 through #10. A two-piece custom zirconia device was utilized to achieve multidimensional augmentation of a severely deficient alveolar ridge. Results: The procedure was well tolerated, resulting in favorable alveolar ridge volume for dental implant placement. Exposure of the device occurred at postoperative week 13. One of two planned implants were stabilized in the augmented alveolar ridge. At the #10 position a palatal dehiscence defect was noted during osteotomy preparation, and additional grafting was required. Conclusions: The custom zirconia device design shown in this report permitted convenient intraoperative packing of bone biomaterial and minimized loss of regenerative space during healing. The protocol relies upon technology that is increasingly accessible to periodontists and has the potential to substantially simplify a technique-sensitive procedure. Envisioned design improvements are presented.

Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: A systematic review. Part I: Clinical trials.

Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but its clinical effectiveness remains undetermined. This systematic review aimed to comprehensively investigate BR grafts in diverse scenarios of ridge defect with simultaneous or staged implant placement. Electronic retrieval of MEDLINE, Embase, Cochrane Library(CENTRAL), Web of Science, Scopus, and citation search until August 3, 2023, was used to identify relevant clinical articles that utilized BR grafts for ridge defect reconstruction. The quality of evidence in the studies reviewed was assessed with the Joanna Briggs Institute Critical Appraisal tool. The protocol was registered in Prospective Register of Systematic Reviews (CRD42023453943). Fourteen studies with 251 BRs were identified, of which 8 studies were for alveolar ridge augmentation, 4 studies were for extraction socket augmentation, and 2 studies were for sinus floor elevation. Reported sources of BRs included autografts, allografts, and xenografts. The follow-up period ranged from 4 months to 4.7 years. Regarding the primary outcomes, the utilization of BR grafts demonstrated favorable bone gain along with acceptable graft absorption and marginal bone loss. Regarding the secondary outcomes, satisfactory bone mineral density and implant stability were confirmed, accompanied by a recorded incidence of postoperative complications (20 cases) and an implant failure rate of 5.58%. BR grafting with simultaneous or staged implant insertion is an effective approach for reconstructing alveolar ridge deficiencies. The BR grafts demonstrate favorable bone remodeling and osteointegration with the alveolar bone and implant; however, its success may be compromised by complications. Future studies should further investigate the clinical efficacy of BR grafting comparing to other bone augmentation techniques in diverse scenarios.

Influence of Narrow Titanium Dental Implant Diameter on Fatigue Behavior: A Comparison between Unitary and Splinted Implants.

Background: Scientific literature lacks strong support for using narrow diameter implants (NDI) in high masticatory force areas, especially in molars. Implant splinting in cases of multiple missing teeth reduces lateral forces, improves force distribution, and minimizes stress on implants. However, no studies have evaluated the fatigue load resistance of unitary or splinted implants. Methods: This in vitro study compares five groups of new metal alloy implants, including unitary and splinted implants with varying diameters. Mechanical characterization was assessed using a BIONIX 370 testing machine (MTS, Minneapolis, MN, USA) according to ISO 14801. For each of the five study sample groups, (n = 5) specimens underwent monotonic uniaxial compression at break testing and (n = 15) cyclic loading to determine the maximum force (Fmax) and the fatigue life (LF) values. Scanning electron microscopy (SEM) was employed for the fractographic analysis of the fractured samples. Results: The Fmax values for unitary samples ranged from 196 N to 246 N, whereas the two-splinted samples displayed significantly higher values, ranging from 2439 N to 3796 N. Similarly, the LF values for unitary samples ranged from 118 N to 230 N, while the two-splinted samples exhibited notably higher values, ranging from 488 N to 759 N. Conclusions: The observed resistance difference between sample groups in terms of Fmax and LF may be due to variations in effective cross-sectional area, determined by implant diameter and number. Additionally, this disparity may indicate a potential stiffening effect resulting from the splinting process. These findings have significant implications for dental clinical practice, suggesting the potential use of splinted sets of small-sized NDI as replacements for posterior dentition (premolars and molars) in cases of alveolar bone ridge deficiencies.

РОЛЬ ЧАСТОТНО- РЕЗОНАНСНОГО АНАЛИЗА В ИССЛЕДОВАНИИ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ, УСТАНОВЛЕННЫХ В РЕКОНСТРУИРОВАННЫЕ АЛЬВЕОЛЯРНЫЕ ОТРОСТКИ С НЕБОЛЬШИМ ОБЪЕМОМ КОСТИ ЧЕЛЮСТЕЙ

The use of dental implants being the intraosseous artificial fixtures is often required for orthopedic rehabilitation of completely edentulous patients; for their placement, adequate amount of bone tissue is needed, which in many cases is insufficient due to physiological bone loss, long-term wearing of full dentures, the duration of edentulism and complex clinical situations caused by maxillofacial injuries or general somatic diseases. Implant placement in the above situations requires timely preparation of deficient alveolar ridge by means of osteoplastic surgery. In its turn, the newly formed regenerated bone by its histological, physicomechanical and structural-functional properties can only approach the recipient bone tissue; therefore, the issue of implant osseointegration and its functional loading in regenerated bone remains debatable. This research uses the method of frequency-resonance analysis showing implant stability coefficient numerically equal to the ISQ (Implant stability Quotient) values and reflecting the percentage of the osseointegration area of the intraosseous part of the implant. The results of research obtained by means of frequency-resonance analysis have proved that with the timely start of implant usage and adequate functional loading, ISQ values increase, that is, increases the osseointegration area along the interface of the intraosseous part of the implant placed in regenerated bone. Comparative results of research reflecting ISQ values in 12 months after implant placement in bone augmented using various forms of autogenous bonegrafts, have been presented; therefore, a conclusion can be made that there is a direct relationship between osseointegration under conditions of functional chewing load and the shape and size of autogenous bonegrafts.

Reconstruction of the Atrophic Ridge with Staged approaches with the Autogenous Bone Block and Dental Implant: Case Reports and Literature Review

<p>Dental implant is a common choice for rehabilitation of edentulous areas in modern dentistry. However, alveolar bone destruction due to severe periodontitis, trauma, or other pathological conditions may compromise implant placement in an idea position. Ridge augmentation with autogenous bone blocks can be used to reconstruct the deficiency of the alveolar bone. This article reviewed about the relevant literatures and reported two cases of severe ridge atro¬phy using staged approaches with ridge augmentation using autogenous bone block grafting and implant placement for reconstruction. Case 1 showed alveolar bone destruction caused by severe periodontitis at left maxillary region, which was augmented with the autogenous bone block harvested from mandibular symphysis in combination with FDBA and collagen membrane. Case 2 presented alveolar ridge deficiency after tooth extraction due to severe periodontitis. Ridge augmentation was performed using autogenous bone block harvested from the mandibular ramus along with FDBA and collagen membrane. Both cases showed increased bone volume after ridge augmentation. Implants were successful and presented stable bone level for a follow up period at least one year after implant surgery. The literature review and case reports suggest that with appropriate case selection, careful treatment, and regular maintenance, using autogenous block bone grafts harvested from the mandibular symphysis or ramus for ridge augmentation and implant placement can achieve predictable outcomes.</p> <p> </p>

Complications following alveolar ridge augmentation procedures.

Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth extraction/loss results in alveolar ridge deficiencies. Although RAP-related surgical techniques and biomaterials have been in practice for several decades, outcomes are not always predictable. Post-surgical complications experienced during the early or late wound healing phases may jeopardize the targeted ideal ridge dimensions, required for implant fixture placement, and may have other consequences, such as negatively impacting the patient's quality of life. This review describes reported post-surgical complications following RAP under the following subtitles: complications by tissue type, complications in function and aesthetics, complications by healing time, complications by biomaterial type, and complications by surgical protocol modalities. Specifically, RAP performed by using particulate bone graft substitutes and related complications are explored. Modalities developed to prevent/manage these complications are also discussed.

Ridge Augmentation Procedure: Review and Case Report

Ridge Augmentation procedures involve techniques utilized to increase the dimensions of the alveolar ridge, correcting deficiency in width, height or combination of both beyond the confines of the skeletal envelope of the ridge. The goal of this article is to review classification systems for alveolar ridge deficiencies as well as present on a Case report of effective clinical management for patient with combined horizontal and vertical alveolar ridge deficiency using a titanium mesh membrane.

Efficacy and volume stability of a customized allogeneic bone block for the reconstruction of advanced alveolar ridge deficiencies at the anterior maxillary region: a retrospective radiographic evaluation

ObjectivesThe aim of this retrospective case series was to evaluate the efficacy and volume stability of a customized allogeneic bone block (CABB) for the hard tissue reconstruction of severely atrophied anterior maxillary ridges.Materials and methodsHard tissue alterations between baseline (T1), 2-month follow-up (T2), and 6-month follow-up (T3) cone-beam computed tomography scans were evaluated with semi-automatic segmentation. Following automatic spatial alignment of the datasets, 3D subtraction analysis was performed. The volume stability of the inserted allogeneic bone block was determined on the basis of the ratio of the T3 and T2 hard tissue volumes.ResultsThe newly formed hard tissue volume at T2 averaged at of 0.75 cm3 ± 0.57 cm3, whereas at T3, an average of 0.52 cm3 ± 0.42 cm3 volumetric hard tissue gain could be detected. The T3/T2 ratio was found to be 67.83% ± 18.72% on average. The dice similarity coefficient between the T2 and T3 hard tissue models averaged at 0.73 ± 0.15.ConclusionsCancellous CABBs are a reliable option for the reconstruction of severely atrophied alveolar ridges. The resorption rates of these grafts are similar to those found in the literature; however, with precise manufacturing and proper intraoperative flap management, the resorption rates may be reduced.Clinical relevanceWith precise knowledge of the resorption patterns, the shape of blocks can be altered in the future to compensate for the volumetric loss.

Clinical protocol selection for alveolar ridge augmentation at sites exhibiting slight, moderate, and severe horizontal ridge deficiencies.

What factors identify the optimal bone augmentation techniques for managing slight, moderate, and severe horizontal alveolar ridge deficiency (ARD) at dental implant sites? Horizontal ARD is a concern at a high proportion of sites receiving dental implants, and clinicians have developed a variety of surgical procedures to address such defects. In a particular case, selection of the optimal treatment may depend predominantly on defect severity, location (anterior versus posterior), and configuration (contained versus noncontained). This report provides a framework for selecting an augmentation method when presented with a slight, moderate, or severe horizontal ARD at a site requiring dental implant placement. Multiple treatment options are available for planned implant sites exhibiting horizontal ARD; severe posterior and slight anterior defects intuitively call for different approaches. Although rigid guidelines for selecting the optimal augmentation method do not exist, some techniques are poorly suited for esthetically demanding sites. A framework considering defect severity, location, and configuration may help guide clinical decisions on this topic.

Complications and treatment errors in peri-implant hard tissue management.

Bone augmentation procedures aim to regenerate the deficient alveolar ridge to properly place dental implants that are completely surrounded by bone. However, these are invasive and technically demanding surgeries that are not free of either complications or treatment errors. Careful patient selection and preparation is a mandatory process to reduce the rate of complications in bone regeneration procedures, irrespective of the technique used. It is important to assess the cost benefit of the intervention and to evaluate the potential impact on the patient's quality of life, especially in the elderly and medically compromised patients. Most common postoperative complications are wound dehiscences, which may be reduced, at least partially, by proper knowledge of the surgical technique and the craniofacial anatomy. Other complications that may appear are postoperative infections or nerve injuries. The aim of this narrative review is to summarize the best available scientific evidence on the incidence of complications, as well as the ideal strategies for their prevention and management. Depending on the severity of the complication, treatment approaches may vary and can include drug prescription or even surgical re-entries to remove exposed barrier membranes or contaminated bone grafts. Adequate prevention and proper management of complications associated with bone augmentation interventions are a requirement for clinicians carrying out these demanding procedures. A series of cases illustrating proper management of complications in different clinical scenarios is presented.

Patient-centered outcome measures comparing the autogenous and allogenic bone blocks in the augmentation of deficient alveolar ridges: A pilot study.

The aim of the present study was to evaluate and compare the patient-reported experience and outcome measures (PREMS and PROMS) and three-dimensional augmentation efficacy of the autogenous and allogenic bone block grafts in deficient alveolar ridges through cone beam computed tomography (CBCT). Twenty patients were equally divided into Groups I and II treated with autogenous and allogenic bone block grafts for ridge augmentation, respectively. The radiographic parameters including the apico-coronal defect height (DH) as well as buccolingual defect depth (DD) and mesiodistal defect width (DW) at apical, middle, and cervical zone were measured using CBCT at baseline, 6 months and 1 year. The PREMS and PROMS were evaluated using Visual analogue scale (VAS) scale and questionnaire method. The mean DH, apical DD and DW, middle and cervical zone DW were significantly different between two study groups (P < 0.05). The mean apical 11.6 ± 1.91 and middle zone 9.43 ± 0.89 DD were significantly higher (in Group I as compared to Group II, with P values 0.016 and 0.004, respectively). The mean bone gains in apico-coronal DH and mesio-distal DW dimension in the apical and middle zone was significantly higher in Group I (P < 0.0001). The comparison of PROM revealed better patient satisfaction in Group II as depicted by significantly higher VAS score (P < 0.0001). Superior bone gain and reduced graft resorption was observed in Group I when compared to Group II. On the contrary, better PROMs and PREMs were obtained with the allogenic bone block augmentation.

Comparison of Implant Success Rate Between Direct And Indirect Sinus Lift Procedure

Objective: The objective of the study is to compare gain in bone height and post-operative complications e with direct and indirect sinus lift procedure. Methods: This prospective clinical study was conducted at the department of Science of Dental Materials, University Medical and Dental college Faisalabad, in a period of one year from November 2021 to November 2022. For patients in the 20-50 years age range either gender with maxillary posterior edentulous regions but with a low sinus and deficient alveolar ridge, implant retained prostheses would be a viable option. Results: Results showed that pain and gingival inflammation resolved at 1st week postoperatively. These two parameters frequency was higher in patients with indirect method as compared to patients who were treated with direct method. Swelling was also settled in both treatment groups after 1st week postoperatively. However, frequency of swelling was higher in indirect method as that of direct method but the difference was not statistically significant. There is significant change in bone height postoperatively in both treatment groups. But gain in mean bone height was significantly higher in patients treated with direct approach. Conclusion: This study did not find a significant difference between direct versus indirect sinus lift procedures in terms of swelling, inflammation, and pain following surgery. Indirect sinus lifts, however, result in a significantly lower bone height gain than direct sinus lifts. Â Key Words: Edentulism, Sinus lift procedures, Direct, Indirect, Bone height, Sinus surgery.

Anterior Aesthetic Zone Reconstruction with Allogenic Bone Shell and Autogenous Bone Chips - An Evaluative Study.

Horizontal alveolar bone loss hinders dental implant placement. Reconstruction of alveolar deficiency is mandatory to establish an ideal foundation for implant-supported prosthetic restoration. The aim of this study is to evaluate the regenerated bone following anterior aesthetic zone reconstruction with allogenic bone shell and autogenous chips. A total of 15 deficient sites in the aesthetic zone were treated using allograft bone shells, which were fixed away from the alveolar ridge using microscrews, and the created gap was filled with autogenous chips harvested intraorally using a bone scraper. Clinically, one patient experienced wound dehiscence in the second post-operative week, and the graft had to be removed one month postoperatively due to infection. Three patients experienced shell detachment six months later but that did not hinder the placement of an implant. Radiographically, there was horizontal bone gain that was statistically significant six months postoperatively. The mean apical bone gain was 2.64 mm (±0.99 standard deviation [SD]). The mean mid-level bone gain was 3.44 mm (±0.52 SD). The mean crestal bone gain was 2.36 mm (±0.85 SD). Histologically, vital trabecular bone tissue with osteocytes and osteoblasts was detected. Moreover, the presence of reversal lines indicated bone formation and remodelling after grafting. This technique generates sufficient bone tissue in previously horizontally deficient alveolar ridges for subsequent implant placement and omits the need for a second surgical site with its consequent morbidity. The low complication rate reported needs further modifications to extrapolate results.