Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial

Background The sandwich osteotomy technique usually requires high surgical skills and prolonged intraoperative time and had some technical drawbacks with a subsequent deficient amount of vertical bone gain. The aim of this study was to evaluate the final vertical bone gain using sandwich osteotomy with simultaneous versus delayed implant placement in the anterior maxilla. Material and methods This study included 16 patients having multiple missing maxillary anterior teeth with a vertically deficient alveolar ridge. Patients were randomly assigned into two equal groups. Both groups were treated using sandwich osteotomy with interpositional particulate bovine bone graft. In the study group (8 patients, 17 implants), the transport mobilized bone segment was fixed in position using simultaneous implant placement. Whereas in the control group (8 patients, 18 implants), micro-plates and screws were used, followed by a second-stage surgery for plates removal and delayed implant placement. Radiographic assessment included 4 months postoperative mean of vertical gain in alveolar ridge height, taken from cross-sectional cuts of cone beam CT. Results The mean vertical bone gain in the study group was 4.04 +/- 0.59 mm compared to 3.86 +/- 0.52 mm in the control group with no statistically significant difference (p = 0.518). The mean value of bone gain percentage in the study group was 33.02% compared to 31.75% in the control group, with no statistically significant difference (p = 0.656). Conclusion The sandwich osteotomy technique with simultaneous implant placement is a reliable method for vertical ridge augmentation that eliminates the need for a secondary surgery.