Split-Block Graft Versus Cortico-cancellous Block Graft for Horizontal Ridge Augmentation: Cone Beam Computed Tomography and Histomorphometric Study


  • Mina Botros Assistant Researcher
  • Hala Kamal Adbel Gaber Professor, Department of Oral Diagnosis, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
  • Effat Abbas Professor of Oral Pathology, Department of Basic Dental Sciences, National Research Center, Dokki, Giza, Egypt
  • Mohamed El-Mofty Vice-Dean for Post-graduate Affairs & Research, Faculty of Dentistry, Nahda University, Bani Sweif, Egypt. Assistant Professor, Department of Oral Diagnosis, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
  • Mohamed Bissar Lecturer, Department of Oral Diagnosis, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt




Objective: The aim of this study was to compare the horizontal dimensional changes of split-bone block and cortico-cancellous block graft in horizontal ridge augmentation using Cone Beam Computed Tomography (CBCT). The quality of the regenerated bone in both groups was compared histologically and histomorphometrically. Material and methods: Twenty patients were randomly divided in two equal groups (n= 10): Split-bone block group which was harvested from the external oblique ridge or cortico-cancellous block graft group which was harvested from the mandibular symphysis. Pre-augmentation crestal ridge width was measured using bone caliper. CBCT scans were taken on the 2nd week and 4th month post-operatively to measure crestal and total horizontal ridge dimensions. A biopsy was collected from the regenerated ridge immediately before implant insertion on the 4th month post-operatively. Results: Pre-augmentation crestal bone widths of both groups were comparable (P= 0.870). On the 2nd week and 4th month post-operatively, split-bone block showed a significantly wider crestal (P= 0.028 and P= 0.001 respectively) and total horizontal ridge dimension (P= 0.025 and P= 0.002 respectively), and on the 4th month post-operatively, it showed significantly lesser resorption at crest (P= 0.040) and in total horizontal ridge dimension (P= 0.017) than cortico-cancellous block. Histologically, the regenerated bone quality was similar in both groups. Histomorphometric analysis showed a non-significant difference in percentage of mature (P= 0.365) and immature collagen (P= 0.531) between both groups. Conclusion: Split-bone block maintained a significantly wider ridge and experienced less resorption after 4 months than the cortico-cancellous block graft, with no difference in regenerated bone quality between both groups.



Dental implants; CBCT; Cortico-cancellous block graft; Histomorphometric analysis; Split-bone block technique.


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2021-04-09 — Updated on 2021-07-30




Clinical or Laboratorial Research Manuscript