Carrot Technique Versus Guided Bone Regeneration for Horizontal Ridge Deficiency in the Maxillary Esthetic Zone

Evaluation of the Carrot Technique With Simultaneous Implant Placement for Horizontal Alveolar Ridge Deficiency in the Maxillary Aesthetic Zone: A Randomized Controlled Clinical Trial.

This randomized controlled clinical trial aims to compare the effectiveness of the Carrot Technique and Guided Bone Regeneration (GBR) for the management of horizontal alveolar ridge deficiency in patients requiring implant placement in the maxillary esthetic zone. Twenty patients will be randomly allocated into two equal groups. Clinical outcomes including implant stability and soft tissue healing, as well as radiographic outcomes including alveolar ridge width, bone density, and marginal bone loss, will be evaluated using clinical examinations and cone beam computed tomography (CBCT) during a 12-month follow-up period..

Study Overview

• Status: Active, not recruiting
• Conditions: Partial Edentulism; Horizontal Alveolar Ridge Deficiency
• Intervention / Treatment: Procedure: Carrot Technique; Procedure: Guided Bone Regeneration

Detailed Description

The Carrot Technique is a minimally invasive approach that utilizes an autogenous bone core harvested during implant osteotomy and repositioned to augment the deficient buccal ridge. This technique may reduce donor-site morbidity while providing sufficient horizontal bone augmentation. Guided Bone Regeneration remains one of the most widely used techniques for horizontal ridge reconstruction through the use of bone substitute materials and barrier membranes.

This randomized controlled clinical trial will compare the clinical and radiographic outcomes of the Carrot Technique and GBR in patients presenting with horizontal ridge deficiency in the maxillary esthetic zone. Twenty patients requiring single-tooth implant rehabilitation will be randomly allocated into two equal groups. Group I will receive implant placement combined with the Carrot Technique, while Group II will receive implant placement combined with Guided Bone Regeneration.

Clinical evaluations will include implant stability assessed by resonance frequency analysis, soft tissue healing using the Landry Healing Index, and peri-implant inflammation using the modified sulcus bleeding index. Radiographic evaluation will be performed using cone beam computed tomography immediately after surgery and at 6 and 12 months postoperatively to assess changes in alveolar ridge width, bone density, and marginal bone loss. The study aims to determine whether the Carrot Technique provides comparable or superior outcomes to GBR for horizontal ridge augmentation associated with implant placement.

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

Contacts and Locations

Study Locations

• Egypt
  • Al Mansurah, Egypt
    • Faculty of Dentistry, Mansoura University
  • Dakahlia Governorate
    • Al Mansurah, Dakahlia Governorate, Egypt, 35511
      • Faculty of Dentistry, Mansoura University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients aged 18 to 45 years. Missing a single tooth in the maxillary esthetic zone requiring implant placement.

Good oral hygiene and patient compliance. Medically free from systemic diseases that contraindicate implant surgery. Slight to moderate horizontal alveolar ridge deficiency with a minimum ridge width of 5 mm.

Adequate vertical bone height for implant placement. Medium to hard bone quality (D2-D3 according to Misch classification). Absence of bruxism or other parafunctional habits.

Exclusion Criteria:

• Presence of local pathological lesions (e.g., cysts or tumors) at the planned surgical site.

Poor bone quality (D4 bone). Pregnancy. Heavy smoking. Any medical condition contraindicating implant surgery.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Carrot Technique; Implant placement with horizontal ridge augmentation using an autogenous bone core harvested with a trephine drill from the implant osteotomy site and fixed buccally using osteosynthesis screws.	Procedure: Carrot Technique; Implant placement with simultaneous horizontal ridge augmentation using an autogenous bone core harvested from the implant osteotomy site with a trephine drill and fixed buccally using osteosynthesis screws.
Active Comparator: Guided Bone Regeneration; Implant placement with horizontal ridge augmentation using bone substitute material and a collagen membrane according to guided bone regeneration principles.	Procedure: Guided Bone Regeneration; Implant placement with simultaneous horizontal ridge augmentation using bone substitute material and a collagen membrane according to guided bone regeneration principles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Alveolar Ridge Width	Horizontal alveolar ridge width measured using cone beam computed tomography (CBCT). Changes in ridge width will be calculated by comparing measurements obtained immediately after surgery and at follow-up.	baseline and 12 Months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Marginal Bone Loss	Marginal bone loss measured radiographically using CBCT using the implant as a reference.	12 Months
Soft Tissue Healing	Soft tissue healing assessed using the Landry Healing Index.	1 Week, 2 Weeks, and 1 Month
Modified Sulcus Bleeding Index	Peri-implant soft tissue inflammation assessed using the Modified Sulcus Bleeding Index (mBI).	1 Month and 12 Months
Bone Density	Buccal peri-implant bone density measured using CBCT and expressed in Hounsfield Units.	12 Months
Implant Stability Quotient (ISQ)	Implant stability assessed using resonance frequency analysis and expressed as Implant Stability Quotient (ISQ).	At implant placement and 12 months

Collaborators and Investigators

• Sponsor: Mansoura University
• Investigators: Principal Investigator: Sarah A Elmaghraby, Faculty of Dentistry, Mansoura University, Mansoura, Egypt

Study record dates

Study Major Dates

• Study Start (Actual): August 2, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: June 22, 2026
• First Submitted That Met QC Criteria: June 25, 2026
• First Posted (Actual): June 26, 2026

Study Record Updates

• Last Update Posted (Actual): June 26, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Dental Implant;; Horizontal Ridge Augmentation;; Alveolar Ridge Deficiency;; Guided Bone Regeneration;; Carrot Technique;; Maxillary Esthetic Zone
• Other Study ID Numbers: R.26.02.103

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