Autogenous Bone Block Versus Extended Platelet Rich Fibrin Block for Horizontal Augmentation of Maxillary Ridge With Simultaneous Implant Placement

Autogenous Bone Block Versus Extended Platelet Rich Fibrin Block Used for Horizontal Augmentation of Atrophic Esthetic Zone of Maxillary Ridge Associated With Simultaneous Implant Placement

The aim of the study is directed to assess the clinical and radiographic outcomes of autogenous bone block versus extended PRF block used for horizontal augmentation of atrophied esthetic area of maxillary ridge associated with simultaneous implant placement.

Study Overview

• Status: Active, not recruiting
• Conditions: Extented Platelet Rich Fibrin Block
• Intervention / Treatment: Procedure: group I: autogenous bone block; Procedure: extented platelet rich fibrin

Detailed Description

Twenty implants inserted in 16 patients will be randomly and uniformly distributed into two equal groups:

Group I: Ten dental implants will be inserted simultaneously in eight patients with horizontal ridge augmentation done by symphyseal onlay autogenous block technique.

Group II: Ten dental implants will be inserted simultaneously in nine patients with horizontal ridge augmentation done by onlay extended platelet rich fibrin technique using a mixture of allografts and xenografts.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Al Mansurah, Egypt
    • Mansoura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Maxillary narrow ridge in the esthetic anterior zone (about 4-5 mm in width).
• Bone height allows the insertion of at least 8 mm of implant length without the need for vertical augmentation.
• Patient aged 18-45 years old.
• The presence of enough amount of keratinized gingiva as well as enough space for prosthesis rehabilitation.
• Favorable occlusion without presence of parafunctional habits.
• Cooperative patient with high motivation and acceptable oral hygiene.
• Patients are medically free from systemic diseases or drugs that absolutely contraindicate implant surgery.
• Patients able to comply with the required recall visits.

Exclusion Criteria:

• Local and / or systemic conditions that may affect passively the clinical procedure or results.
• Heavy smokers(>20 cigarettes/d).(1)
• Alcohol or drug abuse.
• Patients with parafunctional habits (bruxism and clenching).
• Pregnancy.
• Uncooperative patients.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group I ( autogenous bone block); Ten dental implants will be inserted simultaneously with horizontal ridge augmentation done by onlay autogenous block technique.	Procedure: group I: autogenous bone block; Full thichness flap is done and the implant is inserted in place. After that, an autogenous block is harvested from the symphyseal area and fixed in the area of the defect
Experimental: Group II ( e-prf block); Ten implants were inserted in 9 patients with horizontal augmentation with eprf block.	Procedure: extented platelet rich fibrin; Full thickness flap is made and the implant is inserted in place. After that the platelet rich fibrin is collected from the patient blood and heated to produce e-platelet rich fibrin, mixed with a mixture of allograft and xenograft to make e-platelet rich fibrin block placed in the defect area

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
bone width	The horizontal bone gain resulted from the ridge augmentation was measured at 2,4,6 mm apical to the alveolar crest level, then the mean was calculated. This calculation was done at T0 (BG0), T3 (BG3) and T6 (BG6).	immediately after augmentation and implant placement (T0), and after 3 months (at time of implant loading) (T3) and after six months from implant loading (T6) (totally, 9 months follow up)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
bone area	The horizontal bone gain area resulted from the ridge augmentation was measured at T0 (BG0), T3 (BG3) and T6 (BG6).	immediately after augmentation and implant placement (T0), and after 3 months (at time of implant loading) (T3) and after six months from implant loading (T6) (totally, 9 months follow up)
marginal bone loss	On the cross-sectional view, a line was drawn buccally and lingually just parallel to the long axis of the implant, starting at the most cervical bone implant contact to the apex of the implant. Bone height in millimeters was recorded at immediate postsurgical phase after implant insertion. Vertical bone loss was calculated by subtracting recorded marginal bone level value buccally and lingullay after 3 months (at time of implant loading (T3) and after 6 months of implant loading (T6) from immediate postoperative value (T0).	immediately after augmentation and implant placement (T0), and after 3 months (at time of implant loading) (T3) and after six months from implant loading (T6) (totally, 9 months follow up)
Relative Alveolar Bone Density	All density records were collected from the cross-sectional view of CBCT using the Hounsfield unit (HU) according to Misch's classification. ROI tool was used representing the average estimated bone density at 3 mid-buccal levels of the placed implant at T0 (immediately after surgery) and after 3 months (at time of implant loading (T3) and after 6 months of implant loading (T6), in comparison to the primary measures.	immediately after augmentation and implant placement (T0), and after 3 months (at time of implant loading) (T3) and after six months from implant loading (T6) (totally, 9 months follow up)
Bone volume	The volume of the gained bone resulted from the ridge augmentation was measured at T0 (BG0), T3 (BG3) and T6 (BG6).	immediately after augmentation and implant placement (T0), and after 3 months (at time of implant loading) (T3) and after six months from implant loading (T6) (totally, 9 months follow up)
Postoperative Pain	- By using a 10-point Visual Analogue Scale (VAS) for assessment of pain by the patient on the 1st, 3rd, and 7th days after augmentation surgery. (0-1=None, 2-4=Mild, 5-7=Moderate, 8-10=Severe)	on the 1st, 3rd, and 7th days after augmentation surgery
Landry Healing Index for Wound Healing Evaluation	- The area of operation was examined by using healing index by Landry et al., this index scores clinical signs and symptoms of infection as redness, hotness, pus discharge, bleeding and pain. In addition to that, any manifestations of wound healing disturbance including wound dehiscence and exposure of underlying bone graft were recorded carefully.	immediately at 14th day during suture removal visit, one month and 3 months after surgery.
Modified sulcus bleeding Index (mSBI)	Clinical signs and symptoms of inflammation of peri-implant mucosa were graded using criteria of mSBI. It was recorded immediately after implant loading and after 6 months of loading at four aspects around the implants; buccal, lingual, mesial, and distal. The four readings were averaged and approximated to nearest 0.5.	It was recorded immediately after implant loading and after 6 months of loading.
Peri-implant pocket depth (PPD)	Depth of the peri-implant sulcus was recorded immediately after implant loading and after 6 months of loading. The distance between the gingival margin and the base of the pocket was recorded using a graduated periodontal probe with light force to avoid undue tissue damage and over-extension into the healthy tissue. The probe was inserted buccally, mesially, lingually and distally around each implant in a line parallel to the implant vertical axis until the blunt end of the probe reached the base of the pocket. The four readings were averaged and approximated to nearest 0.5mm.	immediately after implant loading and after 6 months of loading
Measurement of implant stability	The primary Implant Stability Quotient (ISQ) was measured by using a resonance frequency analyzer (Osstell device) immediately after the placement (T0) and after three months at time of implant loading (T3), then after six months from implant loading (T6). RFA technology depends on fork tuning principle. A Smart Peg was attached to the implant and torqued to 10 Ncm and then the peg was made to vibrate just like a tuning fork by the Osstell device. The purpose here was to find the resonance frequency with the strongest vibration.	immediately after the placement (T0) and after three months at time of implant loading (T3), then after six months from implant loading (T6).

Collaborators and Investigators

• Sponsor: Naira elnagar

Study record dates

Study Major Dates

• Study Start (Actual): May 9, 2024
• Primary Completion (Actual): June 23, 2025
• Study Completion (Estimated): April 1, 2026

Study Registration Dates

• First Submitted: February 14, 2026
• First Submitted That Met QC Criteria: February 14, 2026
• First Posted (Actual): February 20, 2026

Study Record Updates

• Last Update Posted (Actual): February 24, 2026
• Last Update Submitted That Met QC Criteria: February 21, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: extented platelet rich fibrin
• Other Study ID Numbers: A0203024OS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: because the data are secret and only the primary researchers have the right to look at them

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No