Efficacy of Citric Acid on Autogenous Bone Particulates with Different Virtual Designed Meshes in Pre Implant Preparation of Horizontal Ridge Defect (Clinical, Radiographic, Histomorphologic study)

Aim: This study aimed to analyze efficacy of citric acid on autogenous bone particulates with different virtual designed meshes in pre implant preparation of horizontal ridge defect. Subjects and methods: A total of 27 patient with horizontal ridge defect were randomized divided into 3). Group Group I: include 9 Patients with horizontal ridge defect will be treated by autogenous bone graft covered by virtual designed zirconia mesh with citric10%at15 sec(ph1).Group II: include 9 Patients with horizontal ridge defects were treated with autogenous bone graft with virtual designed titanium mesh with citric acid 10% at 15 sec(ph1) Group III: include 9 Patients with horizontal ridge defect will be treated by autogenous bone graft covered by virtual designed Peek mesh with citric acid 10% at 15 sec(ph1). Radiographic assessment by CBCT pre and after 4 month and after 8 months after implant placement, histological assesment were performed. Results: wound healing was un eventual for all patients. CBCT scan were requested preoperatively, postoperative after mesh removal at 4 month and 8 months after implant placement, core biopsy was taken before implant placement. In all groups there were a significant increase in mean value of bone width (p value <0.05) when comparing each time interval with baseline as mean bone width for Group I (zirconia mesh) was 4.3±0.37 preoperative and increase to 7.6±0.83 postoperative then decline again to 7.18 ±0.82after 4 month and finally become 6.97±0.78after 8 months.for Group II (titanium mesh), 4.08 ±0.30 preoperative and increase to 7.5 ±0.44 postoperative then decline againto 6.93 ±0.44 after 4 month and finally become 6.65±0.41 after 8 months.for Group III (Peek mesh) , bone width was 4.2 ±0.52 preoperative and increase to 7.73±0.40 postoperative then decline again to 6.46 ± 0.32 after 4 month and finally become 6.2±0.51 after 8 months. Conclusion: Demineralization of fresh autogenous bone graft with citric acid can be used for promoting new formation in augmentation procedure. All using material exhibit successful ridge augmentation. Virtual three- dimensional alveolar ridge augmentation using zirconium sheets appear superior, therefore considered a successful ridge augmentation.