Conventional Flap Versus Vestibular Flap in Bone Augmentation ((RCT))

Экспериментальный: vestibular flap group

Процедура: vestibular shifted flap for bone augmentation

The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization.

• Full thickness Vestibular flap and 2 horizontal releasing incision are made (Key Concept: The vestibular shifted flap provides additional flap length by translating vestibular mucosa coronally while preserving keratinized tissue and blood supply)
• Flap elevation: Full thickness flap in the Donor site
• Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested.
• Blocks are carefully shaped into flat "plates."

• The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension

  . • The space between the host bone and the fixed cortical plates is filled with bone particles.

• Tension free bilayered suturing.

Активный компаратор: conventional flap group

Процедура: conventional flap

The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization.

• Full thickness conventional flap and 2 horizontal releasing incision are made
• Flap elevation Full thickness flap in the Donor site
• Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested.
• Blocks are carefully shaped into flat "plates."
• The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension.
• The space between the host bone and the fixed cortical plates is filled with bone particles.
• Tension free bilayered suturing

Horizontal Bone Gain Assessed in millimeters by Cone-Beam Computed Tomography (CBCT)

Horizontal bone gain will be evaluated using cone-beam computed tomography (CBCT). Alveolar ridge width will be measured in millimeters (mm) at standardized reference points before the augmentation procedure and at 6 months postoperatively. The outcome will be calculated as the change in ridge width (mm) from baseline to follow-up.

Width of Keratinized Tissue Assessed by Periodontal Probe

The width of keratinized tissue will be measured clinically using a calibrated periodontal probe and recorded in millimeters (mm) at baseline and 6 months postoperatively. The outcome will be calculated as the change in keratinized tissue width from baseline to follow-up.