Evaluation of Endosseous Implants in One Stage Ridge Splitting Using the Conventional Technique Versus the Use of Piezo Surgery in the Maxilla
* The selected patients will be informed of the nature of the research work and informed consent will be obtained. * Patients of both groups will be subjected to CBCT. * Intra operative procedures (for both groups) followed by CBCT will be taken for every patient after 4 months. * Infiltration local anesthesia will be given to the patient (Articaine 4% 1:100 000 epinephrine) Both the study and control group will receive: * In Recipient site, full thickness mucoperiosteal flap pyramidal flap, reflection using mucoperiosteal elevator. * The defective site is reevaluated. * Flap advancement inorder to allow tension free flap closure. * In the Study group: Piezo surgery bone inserts is used to cut crestal osteotomies. * In the Control group: Bone discs diameter is used. * Followed by, the use of bone chisels. * The point and pilot implant drills are used followed by bone expanders. Based on the preexisting bone, the defect morphology and bone quality. The implant is submerged below the alveolar crest to compensate for crestal bone resorption. * Following partial immobilization of the buccal bone segment either book or island pattern. The fixture is inserted submerged below the alveolar bone crest. Followed by bone smoothening and roundation under external saline irrigation at recommended speed of 38000rpm and gear ratio 1:1 calibrated on fesiodespenser. * Xenogenic bone particle size of 0.5 mm to 1mm is going to be condensed into the dead space. * Recheck adequate flap advancement to allow tension free closure. * Double line closure using horizontal mattress followed by interrupted sutures to allow contact area and wound edge eversion.
• Patients with maxilla residual alveolar bone height not less than 8 mm.
• Alveolar bone width from 5mm to 3mm.
• Both genders.
• At least single missing tooth.
• Previous failed implants.
• Tapered or cylinder cross sectioned alveolar bone defect pattern.