Novel Double Expansion Technique Versus Ridge Splitting for Immediate Implant Placement in Narrow Ridges: A Randomized Trial

Background Horizontal deficiency of the alveolar ridge is a challenging condition for dental implant (DI) placement. Although the ridge splitting technique (RST) is very successful, the associated marginal bone loss (MBL) is a critical drawback. The current study aimed to present and compare a novel technique, the double expansion technique (DET), with the RST. Methods A total of 40 patients (57 DI) with narrow ridges were randomly allocated to the control group employing RST, and to the study group employing DET. DI was then immediately placed. Primary stability was measured at the time of implant placement. Secondary stability, marginal bone loss (MBL), keratinized mucosa width (KMW), the plaque index (PI), the bleeding index (BI), and probing depth (PD) were assessed at baseline (time of definitive abutment and temporary crown placement) and then at 3, 6, and 12 months. Pain and the number of analgesic tablets consumed were assessed daily during the first postoperative week. Results The study group had lower pain levels during the first two postoperative days. The study group presented greater primary and secondary stability at baseline and at 3 months. Moreover, it had less MBL at all time points and more KMW at the sixth and twelfth months. Otherwise, both groups showed comparable results regarding the PI, BI, and BD. Conclusion The study group had superior performance, which may be attributed to the lower degree of trauma. Clinical trial registration number: Thai Clinical Trials RegistryTCTR20250226005 at 26/2/2025 (Retrospectively registered)