Comparison of Split Box and Split Bone Block Techniques in Horizontal Ridge Augmentation (SBBTvsSBT)

Comparison of Radiological Bone Gain and Resorption Between the Split Box Technique and the Split Bone Block Technique, and Evaluation of Implant Survival: a Retrospective Study

Horizontal alveolar ridge deficiencies may prevent the placement of dental implants and often require bone augmentation procedures before implant treatment. Two techniques commonly used for horizontal ridge augmentation are the Split Box Technique and the Split Bone Block Technique.

This retrospective study included patients treated at Marmara University Faculty of Dentistry between January 2014 and January 2026. Radiographic records were reviewed to evaluate bone gain after augmentation and the stability of the augmented bone during long-term follow-up. Implant survival after prosthetic rehabilitation was also assessed.

The purpose of this study was to compare the long-term outcomes of the Split Box Technique and the Split Bone Block Technique in terms of bone gain, bone stability, and implant survival.

Study Overview

• Status: Completed
• Conditions: Horizontal Alveolar Ridge Deficiency
• Intervention / Treatment: Procedure: Split Bone Block Technique; Procedure: Split Box Technique

Detailed Description

Horizontal alveolar ridge deficiencies often require augmentation procedures before dental implant placement. Among the available augmentation methods, the Split Bone Block Technique (SBBT) and the Split Box Technique (SBT) are autogenous bone augmentation approaches designed to increase horizontal ridge width and facilitate implant-supported rehabilitation.

The aim of this retrospective study was to compare the radiological outcomes of SBBT and SBT with respect to horizontal bone gain, long-term bone stability, and implant survival. In addition, postoperative complications associated with both techniques were evaluated.

Patients treated between January 2014 and January 2026 at the Department of Oral and Maxillofacial Surgery, Marmara University Faculty of Dentistry, were retrospectively screened. Patients who underwent horizontal ridge augmentation using either SBBT or SBT and had complete radiographic follow-up records were included in the study.

Cone-beam computed tomography (CBCT) images obtained preoperatively, 6 months after augmentation, and during long-term follow-up after prosthetic rehabilitation were used to assess changes in horizontal bone width and graft stability. Radiological measurements were performed to evaluate bone gain after augmentation, dimensional changes during follow-up, and long-term maintenance of the augmented ridge.

The primary outcome measures were horizontal bone gain and long-term bone resorption. Secondary outcome measures included implant survival following definitive prosthetic rehabilitation and the occurrence of postoperative complications.

The study was designed to determine whether the Split Box Technique and the Split Bone Block Technique provide comparable long-term clinical and radiological outcomes for the treatment of horizontal alveolar ridge deficiencies prior to implant placement.

• Study Type: Observational
• Enrollment (Actual): 31

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye), 34854
      • Marmara University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of adult patients with horizontal alveolar ridge deficiencies who underwent horizontal ridge augmentation using either the Split Box Technique or the Split Bone Block Technique before implant placement. Patients were treated at Marmara University Faculty of Dentistry between January 2014 and January 2026 and had complete clinical records and CBCT imaging available for retrospective evaluation.

Description

Inclusion Criteria:

• Age ≥18 years.
• Patients with horizontal alveolar ridge deficiency requiring horizontal ridge augmentation before implant placement.
• Patients treated with either the Split Box Technique (SBT) or Split Bone Block Technique (SBBT) at Marmara University Faculty of Dentistry between January 2014 and January 2026.
• Availability of complete radiographic records, including CBCT scans obtained preoperatively (T0), 6 months after augmentation (T1), and during long-term follow-up after prosthetic loading (T2).
• Availability of complete clinical records and follow-up data.

Exclusion Criteria:

• Incomplete clinical or radiographic records.
• Patients lost to follow-up.
• Presence of uncontrolled systemic diseases or conditions known to adversely affect bone healing.
• Use of medications known to interfere with bone metabolism or healing.
• Active infection at the augmentation site or complications that altered the planned treatment protocol.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Split Bone Block Technique (SBBT); Patients who underwent horizontal alveolar ridge augmentation using the Split Bone Block Technique.	Procedure: Split Bone Block Technique; Autogenous horizontal ridge augmentation procedure using cortical bone plates harvested from the mandibular ramus to reconstruct deficient alveolar ridges prior to implant placement.; Other Names: SBBT
Split Box Technique (SBT); Patients who underwent horizontal alveolar ridge augmentation using the Split Box Technique.	Procedure: Split Box Technique; Autogenous horizontal ridge augmentation procedure involving mobilization and fixation of a buccal bone segment to increase horizontal ridge width prior to implant placement.; Other Names: SBT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Long-Term Horizontal Bone Gain	Overall change in horizontal alveolar ridge width from baseline to long-term follow-up after prosthetic loading, measured on CBCT images.	From baseline (preoperative CBCT) to long-term follow-up after prosthetic loading(average follow-up: 4.2 years)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Implant Survival Rate	Survival of dental implants placed in augmented sites following prosthetic rehabilitation.	From implant placement through study completion (average follow-up: 4.2 years)
Postoperative Complications	Occurrence of complications related to augmentation procedures, including wound dehiscence, infection, graft exposure, and neurosensory disturbances.	From augmentation surgery through study completion (average follow-up: 4.2 years)
Long-Term Bone Resorption	Change in horizontal ridge width between the post-augmentation healing period and long-term follow-up, measured on CBCT images.	From 6 months after augmentation surgery to long-term follow-up after prosthetic loading (average follow-up: 4.2 years)
Horizontal Bone Gain	Change in horizontal alveolar ridge width from baseline to 6 months after augmentation, measured on CBCT images.	From baseline (preoperative CBCT) to 6 months after augmentation surgery

Collaborators and Investigators

• Sponsor: Marmara University
• Investigators: Principal Investigator: Guhan Dergin, DDS, PhD, Marmara University Faculty of Dentistry

Publications and helpful links

General Publications

• Dergin G, Kirac Can SB, Can S. A novel approach for horizontal augmentation with split box: A method that combines split bone block and ridge split techniques. J Stomatol Oral Maxillofac Surg. 2024 Dec;125(6):101790. doi: 10.1016/j.jormas.2024.101790. Epub 2024 Feb 1.
• Khoury F, Hanser T. Mandibular bone block harvesting from the retromolar region: a 10-year prospective clinical study. Int J Oral Maxillofac Implants. 2015 May-Jun;30(3):688-97. doi: 10.11607/jomi.4117.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2014
• Primary Completion (Actual): January 1, 2026
• Study Completion (Actual): January 1, 2026

Study Registration Dates

• First Submitted: June 5, 2026
• First Submitted That Met QC Criteria: June 16, 2026
• First Posted (Actual): June 18, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 16, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: CBCT; Dental Implants; Bone Resorption; Implant Survival; Split Box Technique; Split Bone Block Technique; Horizontal Ridge Augmentation
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Bone Resorption
• Other Study ID Numbers: 2025-11-02/2025-86 (Other Identifier: Marmara University Faculty of Dentistry Clinical Research Ethics Committee Approval)

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