Magnetic Mallet and Piezotome in Atrophic Anterior Maxillary Ridge Expansion With Simultaneous Bone Graft and Implant Placement (

Comparison Between Magnetic Mallet and Piezotome in Atrophic Anterior Maxillary Ridge Expansion With Simultaneous Bone Graft and Implant Placement (Randomized Clinical Trial)

Background: teeth loss in the anterior maxilla initiate residual ridge resorption, especially in the anterior region. The consequence of this resorption is a gradual medial or palatal shift of the crest of maxilla. This results in change in facial morphology as result of diminished maxillary lip support. This may also lead to compromised occlusal relationship of prosthetic teeth as they are positioned labially to the crest of alveolar ridge.

Aim: to compare the use of magnetic mallet and piezotome in atrophic anterior maxillary ridge expansion with simultaneous bone graft and implant placement.Materials and Methods: 20 patients with anterior atrophic maxilla will be included in the study. Patients will be divided into two groups, group A the bone expansion will be done by the magnetic mallet. Group B the bone expansion will be done by the piezotome , both groups will have bone graft and implant.

clinical evaluation will include intra operative and post operative evaluation, primary and secondary stability, operative time and time . Radiographic evaluation will include bone density and marginal bone loss around the tnalpmi

Study Overview

• Status: Completed
• Conditions: Alveolar Bone Loss
• Intervention / Treatment: Procedure: ridge expansion by piezotome; Procedure: ridge expansion by magnetic mallet

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

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt
    • Alexandria Faculty of Dentistry

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• alveolar ridge width from 3-5 mm
• Patient with missing more than two anterior maxillary teeth
• Patient with good oral hygiene and acceptable inter-arch space[8-12mm] for the restoration
• D3 bone density

Exclusion Criteria:

• Heavy smoker, alcohol abuse, parafunctional habits.
• Patient with uncontrolled hypertension, uncontrolled diabetes, on radiation therapy

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group	Procedure: ridge expansion by magnetic mallet; Surgery will be performed under local anesthesia using articaine with 1:100,000 adrenaline, a full-thickness buccal and palatal flaps will be raised. After the flaps were reflected, the crestal incision will be performed into the bone to perform an intra-osseous groove with an n. 64 beaver blade attached to magnetic mallet, this groove will be continued apically down to 7-11mm. The implant site will be created by expanding the bone tissue both laterally against the preexisting walls and apically by using osteotome attached to magnetic mallet, in this way the buccal plate will be slowly dislocated in a facial direction.
Experimental: Study group	Procedure: ridge expansion by piezotome; Surgery will be performed under local anesthesia using articaine with 1:100,000 adrenaline, after exposing the ridge, a sagittal osteotomy of 1mm depth will be outlined in the cortical bone by using sharp piezoelectric insert no. OT2. After that the sagittal osteotomic cut will be deepened with a 0.25 mm diameter piezoelectric micro-saw no. OT12s toward apical direction, at depth equivalent to the planned implant length. When the bone cuts will be completed, the ridges will be separated in buccal/lingual direction using densah burs . Then implants will be placed within the confines of the newly created space .

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
secondary implant stability	(2ry stability ) will be recorded after 6 months by using osstell device. The result is presented in form of ISQ value from 1to 100, the higher the ISQ the higher the stability of implant.	up to 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
change in pain scores	Pain will be assessed for 7 days postoperatively using 10-point visual analouge scale (VAS)(0-1=None, 2-4=mild, 5-7=moderate, 8-10=severe )	up to 7 days
change in labial bone thickness	it will be measured on CBCT	baseline and 6 months
Marginal bone loss	it will be measured on CBCT	up to 6 months
change in bone density	it will be measured on CBCT	up to 6 months

Collaborators and Investigators

• Sponsor: Alexandria University

Study record dates

Study Major Dates

• Study Start (Actual): January 19, 2025
• Primary Completion (Actual): July 21, 2025
• Study Completion (Actual): July 21, 2025

Study Registration Dates

• First Submitted: March 9, 2026
• First Submitted That Met QC Criteria: March 9, 2026
• First Posted (Actual): March 12, 2026

Study Record Updates

• Last Update Posted (Actual): March 12, 2026
• Last Update Submitted That Met QC Criteria: March 9, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Bone Resorption; Bone Diseases; Musculoskeletal Diseases; Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Alveolar Bone Loss
• Other Study ID Numbers: 0915-05/2024

Drug and device information, study documents

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