Horizontal ridge augmentation in maxillary esthetic zone using bovine bone graft versus extended sticky bone with simultaneous implant placement: a randomized clinical study

Abstract Background Horizontal ridge deficiency in the anterior maxilla may compromise optimal implant placement and esthetic outcomes. This randomized clinical trial evaluated the clinical and radiographic outcomes of bovine bone graft (Medpark) ® compared with extended sticky bone (ESB) for horizontal ridge augmentation with simultaneous implant placement. Materials and methods Sixteen patients with missed maxillary anterior tooth and horizontal ridge resorption were randomly allocated into two groups ( n = 8 each). Group I received Medpark graft, while Group II received ESB with simultaneous implant placement. Implant stability was assessed immediately and after 6 months. Soft tissue healing was evaluated using the Landry healing index at 2 and 4 weeks. Cone-beam computed tomography (CBCT) was performed preoperatively (T0), immediately postoperatively (T1), and at 6 months (T6) to assess volumetric bone changes. Data were statistically analyzed using SPSS software ( p ≤ 0.05). Results All implants survived without complications. Implant stability increased significantly in both groups at 6 months ( p = 0.001), with no significant intergroup differences. Soft tissue healing improved significantly over time in both groups ( p = 0.008), without significant differences between them. Both groups demonstrated significant bone volume gain at T1 followed by partial reduction at T6, remaining above baseline. A significant difference was observed at T1 in favor of ESB ( p = 0.001), while greater bone loss from T1 to T6 was noted in the ESB group. Conclusion Within the limitations of this study, both Medpark and extended sticky bone demonstrated favorable short-term outcomes for horizontal ridge augmentation. Although extended sticky bone achieved greater immediate postoperative bone volume gain, greater subsequent resorption resulted in comparable clinical and radiographic outcomes between the two groups after 6 months. Further studies with larger sample sizes and longer follow-up periods are required to determine the long-term clinical significance of these findings. Trial registration The study was listed on www.clinicaltrials.gov with registration number (NCT07589426) on 03/05/2026.