A Xenograft versus PRF alone or mixed with metformin in horizontal ridge augmentation with split-crest technique for implant installation.

Objective: To evaluate and compare the efficacy of xenograft and PRF alone, or mixed with metformin, in horizontal ridge augmentation with split-crest technique, for implant placement. Patients & Methods : Eighteen patients with narrow ridges were divided into Group 1: Patients received a split crest technique (SCT) with implant placement and xenograft. Group 2: Patients received an SCT with implant placement and PRF only. Group 3: Patients received an SCT with implant placement and metformin mixed with PRF. Implant stability was recorded immediately after implant placement, and at loading. Modified gingival index (mGI), modified plaque index (mPI), and probing depth (PD) were recorded and repeated after one, 3, and 6 months of prostheses. Alveolar crest width (ACW), crestal bone loss (CBL) as well as relative bone density (RBD) evaluated immediately after surgery, at the time of loading, and 6 months after loading. Results : The mean Alveolar Crest Width (ACW) measurements of the present study showed significantly higher ACW in (SCT / PRF) and (SCT / metformin / PRF) than (SCT / xenograft). CBL at loading and 6 months in favor of xenograft and metformin mixed with PRF groups. Conclusion: Compared to PRF alone, xenograft and 1% MF gel mixed with PRF might provide better implant stability, and less CBL. Both xenograft and 1%MF mixed with PRF may be used as peri-implant graft materials with expected comparable clinical