Clinical and radiographic outcomes of T-shaped versus conventional bone splitting combined with simultaneous bone augmentation for single-tooth implantation: a retrospective comparative cohort study

Bone splitting presents minimal trauma, remarkable bone augmentation effect, high surgical safety and efficacy, and avoids the need for a second donor site. Nevertheless, it still carries risks of severe complications like the intraoperative fracture of the labial bone plate. To compare the clinical and radiographic outcomes of T-shaped and conventional bone splitting in single-tooth implantation with simultaneous bone augmentation for horizontal bone defects. The study was designed as a retrospective comparative cohort study. Patients were not randomly allocated to the two groups. The surgical approach was determined by the temporal stage of surgery: the conventional surgical approach was adopted in the early stage, and the T-shaped surgical approach was used in the later stage. All consecutive patients who met the inclusion criteria during the study period were enrolled in the present study. In total, 27 patients undergoing single anterior tooth implantation in the Implantology Department of Hefei Stomatological Hospital between January 2024 and March 2026 were enrolled. Enumeration data were analyzed by Fisher’s exact test. The independent samples t -test was used for data with normal distribution and homogeneity of variance. Otherwise, the rank-sum test was adopted. Statistical significance was defined as P < 0.05. Both groups showed statistically significant differences in HT0 6m and HT2 6m ( P < 0.05), while no significant difference was observed in HT4 6m ( P > 0.05). Statistical analysis revealed no significant between-group differences in HT0 immed , HT2 immed , and HT4 immed ( P > 0.05). Statistical analysis demonstrated statistically significant intergroup differences in ΔHT0 and ΔHT2 ( P < 0.05), while no statistically significant intergroup difference was found for ΔHT4 ( P > 0.05). The two groups showed no statistically significant differences in the intraoperative labial bone plate fracture, wound inflammation score, early postoperative Visual Analogue Scale (VAS) score and Early Healing Index (EHI) grading ( P > 0.05). For horizontal bone defects in the esthetic zone, T-shaped bone splitting can achieve a better bone thickness at the labial implant shoulder compared with conventional bone splitting. It shows a numerical tendency toward a lower intraoperative labial bone plate fracture rate and does not adversely affect postoperative discomfort or early wound healing compared with conventional bone splitting.