Abstract
BACKGROUND: Horizontal augmentation of the anterior maxilla is a highly demanding and yet predictable procedure. This study aimed to investigate the efficiency and accuracy of a full computer-guided symphyseal shell harvesting and positioning approach versus the conventional procedure for the treatment of horizontally atrophic anterior maxillary ridges. PATIENTS AND METHODS: Twenty patients with horizontally deficient anterior maxilla were randomly allocated into two groups, ten patients each. The study group received a fully guided horizontal augmentation of their atrophic anterior maxillary ridges using symphyseal shells. While the control group received the same treatment but without surgical guides. Bone gain was calculated for both groups and the accuracy of the computer guidance was investigated in the study group. RESULTS: After four months of graft consolidation, there was no statistically significant difference between both groups regarding the horizontal bone gain and the mean bone gain percent, measuring a mean of 3.66 ± 0.63 mm and 105.71% ± 29.75 mm in the guided group while for the control group, it measured 3.33 ± 1.07 mm and 90.41% ±31.77 mm respectively (P-values = 0.4 and 0.28). In the study group, there was no statistically significant difference between the planned and the achieved horizontal augmentation (p = 0.97). CONCLUSION: Despite the lack of statistically significant difference between both groups with regard to horizontal bone gain, computer-guided cortical shell technique allowed for accurate, simple, and safe graft positioning and fixation; it is worth further investigations to explore its different applications. TRIAL REGISTRATION: Retrospectively registered on www. CLINICALTRIALS: gov with ID: NCT05311332 on 27-03-2022. GOV REGISTERED ID: NCT05311332.