Vertical Bone Gain and Neurosensory Affection in Computer Guided vs Conventional Sandwich Osteotomy

Study Overview
=================
Brief Summary
-----------------
The aim of this study was to assess the efficiency of the computer-guided interpositional sandwich osteotomy for the vertical bone gain and effects on vital structures (inferior dental nerve bundle) compared to free hand interpositional osteotomies.

Detailed Description
-----------------
in this research a full digital sandwich osteotomy protocol was conducted to be compared with the conventional protocol. the investigators were seeking to determine the significance of using surgical computer software in sandwich interpositional bone grafting at atrophied posterior mandibles and how efficiently can it affect this technique.

Official Title
-----------------
Assessment of Vertical Bone Gain and Neurosensory Affection in Computer Guided vs Conventional Sandwich Osteotomy Technique in the Atrophied Posterior Mandible: a Randomized Clinical Trial

Conditions
-----------------
Bone Loss

Intervention / Treatment
-----------------
* Procedure: sandwich interpositional bone grafting computer guided
* Procedure: conventional interpositional bone grafting


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: • Edentulous posterior mandibular ridge with vertical loss of alveolar bone with remaining bone height (4-7 mm) above the mandibular canal Good oral hygiene Highly motivated patients Patients seeking fixed prosthesis at posterior mandibular region. Patients willing for a surgical procedures follow-up with an informed consent Age range 20-65 years Exclusion Criteria: • Smokers Individuals with dentulous posterior mandible ridge Medically compromised patients Patients with local pathosis at the surgical area suggested Previously subjected to reconstructive procedures of the posterior mandible

Ages Eligible for Study
-----------------
Minimum Age: 25 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: computer guided sandwich interpositional bone grafting<br>patient specific cutting guide were fabricated to perform the osteotomies ( and another patient specific guide was then fabricated to start the fixation of the cut bony segment a full digital intervention for sandwich interpositional grafting in patients with vertically atrophied mandible (bilateral split mouth study) | Procedure: sandwich interpositional bone grafting computer guided<br>* performing the 2 vertical and the 1 horizontal osteotomies using a cutting patient specific guide and fixation of the vertically elevated bony segment after gap calculation using patient specific fixation guides<br>|
| Active Comparator: conventional sandwich osteotomy interpositional bone grafting<br>conventional interpositional bone grafting was done for patients with vertically atrophied mandibles (bilateral split mouth study) | Procedure: conventional interpositional bone grafting<br>* performing the conventional interpositional sandwich osteotomies free-hand and fixation of the mobilized bone segment free-hand<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| amount of vertical bone gain | measure the amount of vertical bone gained after performing the interpositional sandwich osteotomy | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| neurosensory affection | measure the affection of the inferior alveolar nerve bundle after performing the interpositional sandwich osteotomy | 4 months |