Autogenous Bone Block Versus Extended Platelet Rich Fibrin Block for Horizontal Augmentation of Maxillary Ridge With Simultaneous Implant Placement

The horizontal bone gain resulted from the ridge augmentation was measured at 2,4,6 mm apical to the alveolar crest level, then the mean was calculated. This calculation was done at T0 (BG0), T3 (BG3) and T6 (BG6).

The horizontal bone gain area resulted from the ridge augmentation was measured at T0 (BG0), T3 (BG3) and T6 (BG6).

On the cross-sectional view, a line was drawn buccally and lingually just parallel to the long axis of the implant, starting at the most cervical bone implant contact to the apex of the implant. Bone height in millimeters was recorded at immediate postsurgical phase after implant insertion. Vertical bone loss was calculated by subtracting recorded marginal bone level value buccally and lingullay after 3 months (at time of implant loading (T3) and after 6 months of implant loading (T6) from immediate postoperative value (T0).

All density records were collected from the cross-sectional view of CBCT using the Hounsfield unit (HU) according to Misch's classification. ROI tool was used representing the average estimated bone density at 3 mid-buccal levels of the placed implant at T0 (immediately after surgery) and after 3 months (at time of implant loading (T3) and after 6 months of implant loading (T6), in comparison to the primary measures.

The volume of the gained bone resulted from the ridge augmentation was measured at T0 (BG0), T3 (BG3) and T6 (BG6).

• By using a 10-point Visual Analogue Scale (VAS) for assessment of pain by the patient on the 1st, 3rd, and 7th days after augmentation surgery.

(0-1=None, 2-4=Mild, 5-7=Moderate, 8-10=Severe)

• The area of operation was examined by using healing index by Landry et al., this index scores clinical signs and symptoms of infection as redness, hotness, pus discharge, bleeding and pain. In addition to that, any manifestations of wound healing disturbance including wound dehiscence and exposure of underlying bone graft were recorded carefully.

Clinical signs and symptoms of inflammation of peri-implant mucosa were graded using criteria of mSBI. It was recorded immediately after implant loading and after 6 months of loading at four aspects around the implants; buccal, lingual, mesial, and distal. The four readings were averaged and approximated to nearest 0.5.

Depth of the peri-implant sulcus was recorded immediately after implant loading and after 6 months of loading. The distance between the gingival margin and the base of the pocket was recorded using a graduated periodontal probe with light force to avoid undue tissue damage and over-extension into the healthy tissue. The probe was inserted buccally, mesially, lingually and distally around each implant in a line parallel to the implant vertical axis until the blunt end of the probe reached the base of the pocket. The four readings were averaged and approximated to nearest 0.5mm.

The primary Implant Stability Quotient (ISQ) was measured by using a resonance frequency analyzer (Osstell device) immediately after the placement (T0) and after three months at time of implant loading (T3), then after six months from implant loading (T6). RFA technology depends on fork tuning principle. A Smart Peg was attached to the implant and torqued to 10 Ncm and then the peg was made to vibrate just like a tuning fork by the Osstell device. The purpose here was to find the resonance frequency with the strongest vibration.