Extended Sticky Bone Versus Ethoss Bone Graft In Horizontal Ridge Augmentation With Simultaneous Implant Placement In The Maxillary Esthetic Zone

Aim: This study aimed to compare the clinical and radiographic outcomes of extended sticky bone and Ethoss bone graft in horizontal ridge augmentation with simultaneous implant placement in the maxillary esthetic zone. Materials and Methods: A total of 14 implants placed in maxillary esthetic zone and they were randomly assigned to two equal groups: Group I received Extended Sticky Bone (a composite of albumin-rich PRF, allograft, and xenograft), while Group II received Ethoss (β-tricalcium phosphate and calcium sulfate). CBCT was used to evaluate ridge width and bone volume at baseline, immediately postoperatively, and after 6 months. Implant stability was assessed by ISQ, and soft tissue healing was evaluated using the modified Landry index. Statistical analyses included Friedman and Wilcoxon tests for intragroup comparisons, and Mann-Whitney U for intergroup differences (α = 0.05). Results: There was a significant increase in ridge width over time (p < 0.001), with no significant resorption between immediate and 6-month follow-up (p = 1.000). Mean volumetric bone gain postoperatively was maintained at 6 months, with minimal loss (mean = 1.04 ± 0.70 mm; p < 0.001). Bone density improved from 1.00 to 1.57 (coded scale), and ISQ values increased significantly (Z = 3.407, p = 0.001). No infections or inflammatory signs were observed; all patients achieved excellent soft tissue healing by 6 months. Conclusion: Both grafting materials demonstrated effective and stable horizontal ridge augmentation with high implant stability and optimal tissue healing. Extended Sticky Bone showed slightly greater volumetric preservation, suggesting potential advantages in esthetically sensitive implant sites.