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This study aimed to investigate the efficiency and accuracy of a full computer-guided symphyseal shell harvesting and positioning approach versus the conventional procedure for the treatment of horizontally atrophic anterior maxillary ridges.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients and methods<\/jats:title>\n            <jats:p>Twenty patients with horizontally deficient anterior maxilla were randomly allocated into two groups, ten patients each. The study group received a fully guided horizontal augmentation of their atrophic anterior maxillary ridges using symphyseal shells. While the control group received the same treatment but without surgical guides. Bone gain was calculated for both groups and the accuracy of the computer guidance was investigated in the study group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>After four months of graft consolidation, there was no statistically significant difference between both groups regarding the horizontal bone gain and the mean bone gain percent, measuring a mean of 3.66\u2009\u00b1\u20090.63\u00a0mm and 105.71% \u00b1 29.75\u00a0mm in the guided group while for the control group, it measured 3.33\u2009\u00b1\u20091.07\u00a0mm and 90.41% \u00b131.77\u00a0mm respectively (P-values\u2009=\u20090.4 and 0.28). In the study group, there was no statistically significant difference between the planned and the achieved horizontal augmentation (<jats:italic>p<\/jats:italic>\u2009=\u20090.97).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Despite the lack of statistically significant difference between both groups with regard to horizontal bone gain, computer-guided cortical shell technique allowed for accurate, simple, and safe graft positioning and fixation; it is worth further investigations to explore its different applications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>Retrospectively registered on <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\" ext-link-type=\"uri\">www.clinicaltrials.gov<\/jats:ext-link> with ID: NCT05311332 on 27-03-2022.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trials.gov registered ID<\/jats:title>\n            <jats:p>NCT05311332.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12903-025-06415-2","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T14:33:38Z","timestamp":1751466818000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bone gain and accuracy assessment of computer-guided workflow for horizontal augmentation of atrophic anterior maxilla with symphyseal cortical plates: a randomized controlled trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Dina","family":"Ayman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Shawky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lobna Abdel Aziz","family":"Aly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Mounir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed K. 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Infect Dis Clin North Am. 2021;35(3):575\u2013607. https:\/\/doi.org\/10.1016\/j.idc.2021.04.004.","journal-title":"Infect Dis Clin North Am"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-06415-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-025-06415-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-06415-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T14:33:39Z","timestamp":1751466819000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-025-06415-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6415"],"URL":"https:\/\/doi.org\/10.1186\/s12903-025-06415-2","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]},"assertion":[{"value":"3 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Research protocol and informed consent templates were approved by research ethics committee, Faculty of Dentistry, Cairo University in July 2021, Ref. No. 10721. Informed consent was obtained from all subjects. All experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1039"}}