Radiographic Assessment of Guided Cortical Shell Technique for Horizontal Ridge Augmentation

"This study utilizes two patient-specific 3D-printed surgical guides to enhance precision in bone harvesting and fixation for horizontal ridge augmentation in the anterior mandible.~Chin Harvesting Guide~This tooth-supported guide is placed on the exposed mandibular symphysis to ensure accurate osteotomy cuts for harvesting a cortical bone shell.~It directs piezo drill cuts (superior, inferior, and vertical) to minimize errors and prevent damage to vital structures.~Bone Block Fixation Guide~After harvesting, this guide helps in precise fixation of the cortical shell onto the recipient site.~It includes pre-planned screw holes to ensure stable positioning of the graft and improve surgical accuracy.~These guides enhance precision, reduce surgical time, and improve graft stability, making the computer-guided technique superior to the traditional free-hand method."

In this group, horizontal ridge augmentation of the anterior mandible is performed using a free-hand technique without computer-guided assistance. Autogenous cortical bone is harvested from the mandibular symphysis using a conventional osteotomy performed manually. The harvested cortical shell is adapted and fixated at the recipient site using titanium mini screws, based on the surgeon's clinical judgment and intraoperative assessment. Bone particulate grafting using a 1:1 ratio of autogenous bone and xenograft material is packed into the defect to enhance volume stability. This approach may result in increased variability in graft positioning, longer surgical time, and higher dependence on surgeon experience.