Computer Guided Split Thickness Versus Full Thickness Flap Buccal Bone Lid Approach in Hard Mandibular Pathosis

NCT07338136 | Not Yet Recruiting

• 1 other identifier: omfs3-3-6
• Study Type: interventional
• Target: 26
• Locations: 0 countries
• Sites: N/A

Brief Summary

• Full thickness Buccal bone lid approach is well known and well reported technique with a superiority on preserving bone volume and better bone healing especially when done using piezoelectrical devices when compared to conventional technique for management of mandibular pathosis, however periosteum disturbance have a negative role regarding vascularity and bone healing, by comparing the split thickness VS full thickness flap design with buccal bone lid approach, this study will highlight if the periosteum preserved attached to the lid improve the healing on mandibular bony pathosis.
• Aim of the study: determine the effect of split thickness flap vs full thickness flap using a guided bone lid in hard mandibular pathosis in term of bone healing.

Conditions

Mandibular Diseases; Guided Surgery; Guided Surgery Accuracy

Keywords

buccal bone lid; split thickness flap; computer guided surgery; mandibular pathosis; impacted tooth

Outcome Measures

Primary Outcomes (1)

• • bone defect filling

  bone healing will be measured with Cone beam CT

  6 months

Secondary Outcomes (3)

• • Intra-operative time

  intra operative time needed for both techniques

• • Pain

  first , third . 7th day post operative

• • Accuracy of transfer of the cutting guide

  immediate post operative using the post operative CBCT

Study Arms (2)

computer guided full thickness flap for buccal bone lid approuch in hard mandibular pathosis

ACTIVE COMPARATOR

* After anaesthesia administration, a full-thickness flap will be elevated with one or two releasing incisions. * Guide will be seated according to the pre-planned position. * The bone lid osteotomies will be prepared following the internal profile of the guide using a piezoelectrical device. * The guide will be removed, and the bone lid will be completed and detached. * The bony lid will be saved in saline solution until fixation. * Pathosis will be removed completely, and the lid will be returned and fixed to its original position using one or more screw. * Suturing with primary closure will be obtained. * Immediate post-operative CBCT will be taken

Procedure: computer guided split thickness flap for buccal bone lid approuch

computer guided split thickness flap for buccal bone lid approuch in hard mandibular pathosis

EXPERIMENTAL

* After anesthesia administration, a split-thickness flap will be elevated. * Guide will be seated according to the pre-planned position. * Periosteal incision will be performed following the external profile of the surgical guide. * The guide will be removed, and a minimum periosteal reflection will be done. * The guide will be placed again, and the bone lid osteotomies will be prepared following the internal profile of the guide using piezoelectrical device. * The guide will be removed again, and the bone lid will be completed and detached with its attached periosteum. * The bony lid with its attached periosteum will be saved in saline solution until fixation. * Pathosis will be removed completely, and the lid will be returned and fixed to its original position using one or more screw. * Suturing with primary closure will be obtained.

Procedure: computer guided split thickness flap for buccal bone lid approuch

Interventions

computer guided split thickness flap for buccal bone lid approuch PROCEDURE

* After anesthesia administration, a split thickness flap will be elevated. * Guide will be seated according to the pre-planned position. * Periosteal incision will be performed following the external profile of the surgical guide. * The guide will be removed and minimum periosteal reflection will be done. * The guide will be placed again and the bone lid osteotomies will be prepared following the internal profile of the guide using piezoelectrical device. * The guide will be removed again, and the bone lid will be completed and detached with its attached periosteum. * The bony lid with its attached periosteum will be saved in saline solution until fixation. * Pathosis will be removed completely, and the lid will be returned and fixed to its original position using one or more screw. * Suturing with primary closure will be obtained. * Immediate post-operative CBCT will be taken

computer guided full thickness flap for buccal bone lid approuch in hard mandibular pathosis; computer guided split thickness flap for buccal bone lid approuch in hard mandibular pathosis

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• No sex predilection.
• Age: 18 to 40
• mandibular intra-bony hard pathosis with a diameter ≥1cm with a buccal cortex thickness ≥1mm

You may not qualify if:

• Systemic or local disease/ condition that could affect bone healing
• Diabetics
• patients on systemic corticosteroid
• chemotherapy
• radiotherapy

Sponsors & Collaborators

• Cairo University: lead

Related Publications (8)

• Sivolella S, Brunello G, Panda S, Schiavon L, Khoury F, Del Fabbro M. The Bone Lid Technique in Oral and Maxillofacial Surgery: A Scoping Review. J Clin Med. 2022 Jun 24;11(13):3667. doi: 10.3390/jcm11133667.

  PMID: 35806950 BACKGROUND

• Mounir M, Beheiri G, El-Beialy W. Assessment of marginal bone loss using full thickness versus partial thickness flaps for alveolar ridge splitting and immediate implant placement in the anterior maxilla. Int J Oral Maxillofac Surg. 2014 Nov;43(11):1373-80. doi: 10.1016/j.ijom.2014.05.021. Epub 2014 Jun 25.

  PMID: 24973295 BACKGROUND

• Khoury F, Hanser T. Mandibular bone block harvesting from the retromolar region: a 10-year prospective clinical study. Int J Oral Maxillofac Implants. 2015 May-Jun;30(3):688-97. doi: 10.11607/jomi.4117.

  PMID: 26009921 BACKGROUND

• Gamal AY, Mailhot JM. A novel marginal periosteal pedicle graft as an autogenous guided tissue membrane for the treatment of intrabony periodontal defects. J Int Acad Periodontol. 2008 Oct;10(4):106-17.

  PMID: 19055224 BACKGROUND

• Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hurzeler MB. Bone loss after full-thickness and partial-thickness flap elevation. J Clin Periodontol. 2011 Feb;38(2):157-62. doi: 10.1111/j.1600-051X.2010.01658.x. Epub 2010 Nov 30.

  PMID: 21118288 BACKGROUND

• Degerliyurt K, Akar V, Denizci S, Yucel E. Bone lid technique with piezosurgery to preserve inferior alveolar nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Dec;108(6):e1-5. doi: 10.1016/j.tripleo.2009.08.006.

  PMID: 19913713 BACKGROUND

• Debnath S, Yallowitz AR, McCormick J, Lalani S, Zhang T, Xu R, Li N, Liu Y, Yang YS, Eiseman M, Shim JH, Hameed M, Healey JH, Bostrom MP, Landau DA, Greenblatt MB. Discovery of a periosteal stem cell mediating intramembranous bone formation. Nature. 2018 Oct;562(7725):133-139. doi: 10.1038/s41586-018-0554-8. Epub 2018 Sep 24.

  PMID: 30250253 BACKGROUND

• Abu Hawa MH, Shehri Z, Alkhouri I. Comparison Between the Bone Lid Technique and the Traditional Technique in Surgical Treatment of the Posterior Mandibular Lesions: A Randomized Controlled Trial. Cureus. 2022 Jun 22;14(6):e26223. doi: 10.7759/cureus.26223. eCollection 2022 Jun.

  PMID: 35911276 BACKGROUND

MeSH Terms

Conditions

Mandibular Diseases; Tooth, Impacted

Condition Hierarchy (Ancestors)

Jaw Diseases; Musculoskeletal Diseases; Stomatognathic Diseases; Tooth Diseases

Central Study Contacts

Ahmed M. Salah Azab, bachelor degree

CONTACT

0201010392877; ahmed.azab@dentistry.cu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: doctor

Study Record Dates

• First Submitted: January 3, 2026
• First Posted: January 13, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): April 1, 2027
• Last Updated: January 15, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share