Evaluation of Accuracy of Computer Guided Versus Conventional Segmental Sandwich Osteotomy With Immediate Implant Placement in Vertically Deficient Anterior Maxilla

Study Overview
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Brief Summary
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In conventional segmental sandwich osteotomy technique the moving the transport segment inferiorly to increase the vertical height causes the segment to move bucco-palatally, increasing the horizontal defect. So using the computer guided in segmental sandwich osteotomy and fixation the transport segment hopefully will reduce the bucco-palatal tipping.

Official Title
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Evaluation of Accuracy of Computer Guided Versus Conventional Segmental Sandwich Osteotomy With Immediate Implant Placement in Vertically Deficient Anterior Maxilla

Conditions
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Sandwich Osteotomy

Intervention / Treatment
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* Procedure: computer guided sandwich osteotomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with vertically deficient anterior maxillary ridge a minimum 10 mm. height of alveolar bone. Patients with medical history that did not hinder implant placement (uncontrolled diabetes) and adequate proper oral hygiene. Patients of adequate alveolar bone width. Both genders males and females will be included. Exclusion Criteria: General contraindications to implant surgery. Subjected to irradiation in the head and neck area less than 1 year before implantation. Untreated periodontitis. Poor oral hygiene and motivation. Uncontrolled diabetes. Pregnant or nursing. Substance abuse. Psychiatric problems or unrealistic expectations. Severe bruxism or clenching. Immunosuppressed or immunocompromised. Treated or under treatment with intravenous amino-bisphosphonates. Lack of opposite occluding dentition/prosthesis in the area intended for implant placement. Active infection or severe inflammation in the area intended for implant placement. Need of bone augmentation procedures at implant placement. Unable to open mouth sufficiently to accommodate the surgical tooling. Patients participating in other studies, if the present protocol could not be properly followed. Referred only for implant placement or unable to attend a 5-year follow-up. Requiring only single implant-supported crowns.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: computer guided sandwich osteotomy<br>segmental sandwich osteotomy will be done for vertically deficient ridges in anterior area of the maxilla. Either using surgical guides (Computer guide segmental sandwich osteotomy technique) for study group and conventional segmental sandwich osteotomy technique for control group. | Procedure: computer guided sandwich osteotomy<br>* segmental sandwich osteotomy will be done for vertically deficient ridges in anterior area of the maxilla. Either using surgical guides (Computer guide segmental sandwich osteotomy technique) for study group and conventional segmental sandwich osteotomy technique for control group.<br>|
| Active Comparator: conventional sandwich osteotomy<br>:conventional segmental sandwich osteotomy will be done for vertically deficient ridges in anterior area of the maxilla. | Procedure: computer guided sandwich osteotomy<br>* segmental sandwich osteotomy will be done for vertically deficient ridges in anterior area of the maxilla. Either using surgical guides (Computer guide segmental sandwich osteotomy technique) for study group and conventional segmental sandwich osteotomy technique for control group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bucco - palatal tipping | calculate the amount of bucco-palaltal tipping of mobilized transport segment after 6 months in mm by cone beam CT between both groups. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| marginal bone loss | calculate marginal bone loss in mm by cone beam CT between two groups | 6 months |