One Stage Ridge Splitting Using 2 Different Techniques in the Posterior Mandible

The selected patients will be informed of the nature of the research work and informed consent will be obtained.

The control group ridge splitting with simultaneous implants using the conventional technique and study group ridge splitting with simultaneous implants using the piezo surgery.

* Pre operative procedures Patients of both groups will be subjected to CBCT. * Intra operative procedures (for both groups) followed by CBCT will be taken for every patient after 4 months. * Infiltration local anesthesia will be given to the patient (Articaine 4% 1:100 000 epinephrine).

Both the study and control group will receive:

* In Recipient site, incision of full thickness mucoperiosteal flap inorder to obtain, three-line pyramidal flap, followed by flap reflection. * The defective site is reevaluated. * Flap advancement using periosteal releasing incision. * In the Study group: Piezo surgery bone inserts are used. * In the Control group: Bone discs diameter are used. * Followed by bone chisels. * The point and pilot implant drills are used followed by the sequential use of bone expanders. Based on the preexisting bone, the defect morphology and bone quality. The implant is submerged below the alveolar crest. * The fixture is inserted submerged below the alveolar bone crest followed by bone smoothening and roundation under external saline irrigation at recommended speed of 38000rpm and gear ratio 1:1 calibrated on fesiodespenser. * Xenogenic bone particle size of 0.5 mm to 1mm is going to be condensed into the dead space. * Recheck adequate flap advancement. * Double line closure using horizontal mattress sutures followed by interrupted sutures on top to allow contact area and wound edge eversion.