Horizontal Ridge Augmentation in Maxillary Esthetic Zone Using Bovine Bone Graft Versus Extended Sticky Bone With Simultaneous Implant Placement

This research is designed to evaluate and compare the clinical and radiographic outcomes of bovine bone graft (Medpark) versus extended sticky bone used for horizontal augmentation of atrophied esthetic area of maxillary ridge associated with simultaneous implant placement.

Study Overview

• Status: Completed
• Conditions: Horizontal Alveolar Ridge Resorption
• Intervention / Treatment: Procedure: oral surgery; Procedure: oral surgery

Detailed Description

Patient selection This study will involve sixteen implants inserted in patients with missing upper tooth / teeth in the esthetic zone accompanied by horizontal alveolar ridge resorption, seeking future tooth replacement. The patients will be selected from the Outpatient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University

Inclusion Criteria:

1. Patient aged 18-45 years.
2. Cooperative patient with high motivation and acceptable oral hygiene.
3. Maxillary narrow ridge in the esthetic zone that needed horizontal bone augmentation. (Class I Siebert classification). (22)
4. No deep undercut at the ridge in the buccal aspect.
5. The presence of enough keratinized gingiva(≥3mm).(23)
6. Sufficient inter-arch space to accommodate the future prosthesis. (24)
7. Patients able to comply with the required recall visits.

Exclusion criteria:

1. Local and / or systemic conditions that contraindicate the placement of dental implant or surgery
2. Smokers
3. Pregnancy.
4. Parafunctional habits, including bruxism and clenching.

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Al Mansurah, Egypt
    • Mansoura University
  • Al Mansurah, Egypt
    • Amira Attia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patient aged 18-45 years, Cooperative patient with high motivation and acceptable oral hygiene, maxillary narrow ridge in the esthetic zone that needed horizontal bone augmentation. (Class I Siebert classification) (24),No deep undercut at the ridge in the buccal aspect, The presence of enough keratinized gingiva(≥3mm).(25), sufficient inter-arch space to accommodate the future prosthesis. (26) , and Patients able to comply with the required recall visits.

Exclusion Criteria:

• Local and / or systemic conditions that contraindicate the placement of dental implant or surgery, smokers, pregnancy and parafunctional habits, including bruxism and clenching.

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
Experimental: Eight dental implants were inserted simultaneously with horizontal ridge augmentation using Medpark; For group I, Medpark bone graft was prepared by hydration with sterile saline, gentle mixing, and allowed to partially set before application to the defect site. For group II, extended sticky bone (ESB) was prepared by centrifugation of autologous blood followed by preparation of ALB-PRF and mixing with bone particulates (50:50 allograft: xenograft) to obtain the final graft materia	Procedure: oral surgery; The oral cavity was prepared using 0.12% chlorhexidine mouth rinse for one minute. Local anesthesia was administered using articaine 4% with 1:100,000 epinephrine. A full-thickness mucoperiosteal flap was reflected using a crestal horizontal incision with vertical releasing incisions to expose the surgical site. Osteotomy preparation was performed using a pilot drill to the planned depth at 800-850 rpm under copious sterile saline irrigation, followed by sequential drilling according to the manufacturer's protocol until the final implant size was achieved. The sterile implant was then inserted using a ratchet wrench. Implant stability was immediately assessed using resonance frequency analysis (Osstell device), and cover screws were subsequently placed. For group I, Medpark bone graft was prepared by hydration with sterile saline, gentle mixing, and allowed to partially set before application to the defect site. For group II, extended sticky bone (ESB) was prepared b; Procedure: oral surgery; The oral cavity was prepared using 0.12% chlorhexidine mouth rinse for one minute. Local anesthesia was administered using articaine 4% with 1:100,000 epinephrine. A full-thickness mucoperiosteal flap was reflected using a crestal horizontal incision with vertical releasing incisions to expose the surgical site. Osteotomy preparation was performed using a pilot drill to the planned depth at 800-850 rpm under copious sterile saline irrigation, followed by sequential drilling according to the manufacturer's protocol until the final implant size was achieved. The sterile implant was then inserted using a ratchet wrench. (Fig.1B & Fig.2B) Implant stability was immediately assessed using resonance frequency analysis (Osstell device), and cover screws were subsequently placed. For group I, Medpark bone graft was prepared by hydration with sterile saline, gentle mixing, and allowed to partially set before application to the defect site. For group II, extended sticky bone (ESB) was prepared b
Experimental: Eight dental implants were inserted simultaneously with horizontal ridge augmentation using extended	Procedure: oral surgery; The oral cavity was prepared using 0.12% chlorhexidine mouth rinse for one minute. Local anesthesia was administered using articaine 4% with 1:100,000 epinephrine. A full-thickness mucoperiosteal flap was reflected using a crestal horizontal incision with vertical releasing incisions to expose the surgical site. Osteotomy preparation was performed using a pilot drill to the planned depth at 800-850 rpm under copious sterile saline irrigation, followed by sequential drilling according to the manufacturer's protocol until the final implant size was achieved. The sterile implant was then inserted using a ratchet wrench. Implant stability was immediately assessed using resonance frequency analysis (Osstell device), and cover screws were subsequently placed. For group I, Medpark bone graft was prepared by hydration with sterile saline, gentle mixing, and allowed to partially set before application to the defect site. For group II, extended sticky bone (ESB) was prepared b; Procedure: oral surgery; The oral cavity was prepared using 0.12% chlorhexidine mouth rinse for one minute. Local anesthesia was administered using articaine 4% with 1:100,000 epinephrine. A full-thickness mucoperiosteal flap was reflected using a crestal horizontal incision with vertical releasing incisions to expose the surgical site. Osteotomy preparation was performed using a pilot drill to the planned depth at 800-850 rpm under copious sterile saline irrigation, followed by sequential drilling according to the manufacturer's protocol until the final implant size was achieved. The sterile implant was then inserted using a ratchet wrench. (Fig.1B & Fig.2B) Implant stability was immediately assessed using resonance frequency analysis (Osstell device), and cover screws were subsequently placed. For group I, Medpark bone graft was prepared by hydration with sterile saline, gentle mixing, and allowed to partially set before application to the defect site. For group II, extended sticky bone (ESB) was prepared b

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Implant Stability Quotient (ISQ) Values Assessed by Resonance Frequency Analysis	Implant stability was assessed using resonance frequency analysis (RFA) with the Osstell device and expressed as Implant Stability Quotient (ISQ) values. ISQ scores range from 1 to 100, with higher scores indicating greater implant stability and osseointegration. High stability: ISQ > 70 Medium stability: ISQ 60-69 Low stability: ISQ < 60 Measurements were recorded immediately after implant placement and at the 6-month follow-up.	Baseline and 6 months after implant placement

Collaborators and Investigators

• Sponsor: Mansoura University

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2025
• Primary Completion (Actual): April 1, 2026
• Study Completion (Actual): May 1, 2026

Study Registration Dates

• First Submitted: May 3, 2026
• First Submitted That Met QC Criteria: May 9, 2026
• First Posted (Actual): May 15, 2026

Study Record Updates

• Last Update Posted (Actual): May 15, 2026
• Last Update Submitted That Met QC Criteria: May 9, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: : Medpark; Extended sticky bone; Horizontal ridge augmentation; soft tissue healing; implant stability; bone volume.
• Additional Relevant MeSH Terms: Dentistry; Surgery, Oral
• Other Study ID Numbers: Ms.25.04.21

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