Objective: The present study was conducted to evaluate the effect of soft tissue augmentation using a self-inflating soft tissue expander when performed before horizontal alveolar ridge augmentation on the outcomes of the bone augmentation procedure. The primary outcome is the bucco-palatal radiographical changes in alveolar ridge width, while the secondary outcome is the quality of the augmented bone assessed histomorphometrically. Materials and Methods:Sixteen patients underwent horizontal alveolar ridge augmentation using autogenous bone. For the test group, soft tissue expanders were used in a separate surgery before bone grafting surgery. For the control group, patients received treatment including single surgery of bone grafting associated with periosteal releasing incision. Implants were placed in both groups 6 months after bone augmentation. Bucco-palatal changes in alveolar ridge width were evaluated via cone-beam computed tomography. Augmented bone quality was assessed histomorphometrically.Results: After 6 months, regarding radiographic bone width, there was no statistically significant difference between the two groups, as mean bone width in group I and group II were 8.57 mm and 8.75 mm, respectively. Regarding histomorphometric analysis, Group I showed significantly higher mean bone surface area fraction, higher median mature collagen area fraction, and higher median blood vessel count than Group II (p-value = .012), (p-value = .004), and (p-value = .014), respectively. Conclusion:Within the limitations of the present study, soft tissue expander has no influence on bone width gain after horizontal alveolar ridge augmentation with an autogenous bone block but may have a positive effect on the quality of augmented bone.

Objective:The aim of the present study was to evaluate horizontal alveolar ridge augmentation using autogenous block grafts harvested from mandibular symphysis without barrier membrane in severe maxillary anterior ridge defects. Materials and methods:Six healthy patients with horizontal defects of the maxillary alveolar ridges were selected for alveolar ridge augmentation (class IV atrophy according to Benic and Hammerle classification). These defects were treated by autogenous block onlay grafts harvested from mandibular symphysis protected by anorganic bovine bone particles only. Bone width was assessed preoperative, immediately post-operative and after 6 months at re-entry by cone beam computed tomography.Result: All block grafts sites provided sufficient ridge width for proper implant placement.Mean bone gain was 3.9mm. No soft tissue dehiscence occurred in any of the cases. Conclusion:A combination of autogenous block graft obtained from the symphysis, combined with particulates xenograft alone without barrier membrane is a predictable and successful technique for augmenting maxillary horizontal ridge deficiency.