Evaluation of Dental Implants After Using Several Bone Splitting Techniques

January 11, 2026 updated by: Damascus University

Evaluation of Clinical and Radiographic Outcomes of Immediate Dental Implants After Using Three Bone Splitting Techniques in Narrow Mandibular Alveolar Ridges: A Randomized Controlled Clinical Study

In both complete and partial tooth loss, the use of dental implants as artificial replacements for missing teeth is a well-established and effective treatment modality, leading to high patient satisfaction and improved quality of life (1).

Horizontal deficiencies of the alveolar ridge can hinder implant-supported rehabilitation due to insufficient bone volume to support implant dimensions, negatively affecting the final prosthetic outcome from both functional and esthetic perspectives (2).

The split-crest technique reduces treatment time, the number of required surgical procedures, and the risk of complications, making it more acceptable to patients. Additionally, it allows for dental implant placement during the same surgical procedure and eliminates the need for a donor site for graft harvesting (3).

In this study, patients with posterior tooth loss in a narrow mandibular ridge underwent dental implant rehabilitation following alveolar ridge splitting and expansion performed using osseodensification, piezosurgery, or a magnetic mallet.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The objective of this study is to compare ridge width gain following ridge splitting and expansion with simultaneous implant placement using osseodensification, piezosurgery, or a magnetic mallet in individuals with narrow mandibular alveolar ridges.

Thirty-nine patients will be randomly allocated into three groups. In Group 1, ridge splitting and expansion will be performed using piezosurgery and bone expanders, followed by simultaneous implant placement.

In Group 2, osseodensification burs will be used after ridge splitting, with simultaneous implant placement.

In Group 3, a magnetic mallet will be used after ridge splitting, with simultaneous implant placement.

Study Type

Interventional

Enrollment (Actual)

39

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Syria
      • Damascus, Syria
        • University of Damascus

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 60 years (Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Patients able to attend follow-up appointments.
  2. Alveolar ridges with sufficient height for the placement of a standard dental implant.
  3. Presence of spongy bone with at least 1 mm of width between the cortical plates.
  4. Absence of systemic or local conditions that could affect bone metabolism.

Exclusion Criteria:

  1. Severe concavity on the vestibular or palatal side of the alveolar ridge.
  2. Uncontrolled periodontal disease.
  3. History of radiotherapy in the head and neck region.
  4. Smokers or patients with parafunctional habits.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Osseodensification group:
Ridge splitting and expansion were carried out by creating horizontal and vertical cuts with piezosurgery, followed by expansion of the alveolar ridge using osseodensification burs
Procedure: Osseodensification
Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion with osseodensification burs. Immediate implant placement will then be performed.
Experimental: Magnetic mallet group:
Ridge splitting and expansion were performed using piezosurgery to create horizontal and vertical cuts, followed by chisels with a magnetic mallet to expand the ridge
Procedure: Magnetic mallet
Procedure: Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using chisels with a magnetic mallet. Immediate implant placement will then be performed.
Experimental: Piezo-surgery group
Ridge splitting and expansion were performed with piezosurgery inserts, followed by bone expanders
Procedure: Piezo-surgery
Two horizontal and one vertical osteotomies will be performed using piezosurgery, followed by ridge expansion using piezosurgery inserts and bone expanders. Immediate implant placement will then be performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The marginal bone loss
Time Frame: Assessments will be conducted 4 months after surgery and 6 months after functional loading.
Changes in bone height following ridge splitting and expansion were assessed radiographically. Measurements were performed using cone beam computed tomography (CBCT) and periapical radiography
Assessments will be conducted 4 months after surgery and 6 months after functional loading.
The bone width gain radiographically
Time Frame: At baseline, after surgery, 4 months after surgery, and 6 months after functional loading.
The extent of bony expansion represents the increase in alveolar ridge width in the buccolingual direction, as determined by radiographic assessment using CBCT.
At baseline, after surgery, 4 months after surgery, and 6 months after functional loading.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Implant stability quotients (ISQ)
Time Frame: Measurements will be taken at the time of surgery and again 4 months postoperatively.
The Implant Stability Quotient (ISQ), measured using the MEGA device, provides a numerical assessment of both primary and secondary stability of dental implants. The scale ranges from 1 to 100, with higher values indicating greater stability and a higher likelihood of successful osseointegration.
Measurements will be taken at the time of surgery and again 4 months postoperatively.
Insertion Torque
Time Frame: During the surgical procedure.
The implant insertion torque was measured during implant placement using a dental implant torque wrench and recorded in Newton-centimeters (N·cm).
During the surgical procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Damascus University

Investigators

  • Principal Investigator: Ahmad Albassal, MSc, Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus
  • Study Director: Munir Harfouch, MSc PhD, Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus
  • Study Director: Mazen Zenati, MSc PhD, Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 25, 2023

Primary Completion (Actual)

February 28, 2025

Study Completion (Actual)

June 28, 2025

Study Registration Dates

First Submitted

January 28, 2023

First Submitted That Met QC Criteria

February 7, 2023

First Posted (Actual)

February 9, 2023

Study Record Updates

Last Update Posted (Actual)

January 13, 2026

Last Update Submitted That Met QC Criteria

January 11, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UDDS-OMFS-01-2023

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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