Aim: This study was designed to compare the clinical and radiographic outcomes of narrow maxillary ridge splitting procedure with and without bone graft with simultaneous implant placement.

Materials and Methods:
Twenty patients (14 males and 6 females with a mean age of 57.2 ± 9.7 years) with horizontally deficient maxillary alveolar ridges less than 4mm and requesting the placement of dental implants were included in this study. The patients were divided randomly into two equal groups (Group I and Group II). In group I no bone graft was used while in group II, the inter-bony space between the buccal and lingual plates was filled with bone graft material. Evaluation of both techniques was carried out in terms of implant stability, horizontal bone gain and crestal bone changes.

Results: Implant stability (ISQ) immediate post-operative as well as after two months, there was no statistically significant difference between the two groups. Ridge width (mm) pre-operatively, after one week as well as two months, there was no statistically significant difference between the two groups. Crestal bone changes (mm) whether at the buccal or lingual sides, Group I showed a statistically significant decrease in crestal bone levels compared to Group II.

Conclusion: Restoring adequate maxillary ridge width with simultaneous implant placement was successfully achieved by the ridge splitting technique performed either with or without bone graft. All the implants placed showed excellent level of stability in both groups after 2 months postoperatively.