Background: Simultaneous and staged guided bone regeneration (GBR) is one of the several surgical techniques that have been developed in the past two decades to regenerate bone and thus to allow implant placement in compromised sites (fenestration and dehiscence). It is a surgical procedure that consists of the placement of a cell-occlusive physical barrier between the connective tissue and the alveolar bone defect. The treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabit the osseous wound. Augmentation utilizing guided bone regeneration (GBR) has become a major treatment option to provide optimal bone to support Osseointegrated dental implants. One of the objectives of GBR is the formation of new bone at sites deficient in bone volume. Another objective is to treat fenestrations and dehiscence at implant surfaces as well as defects associated with simultaneous implant placement. GBR has allowed for placement of restorations at a more ideal location in the oral cavity, thus improving esthetics and functions. This study aimed to improve the alveolar ridge width by using of synthetic bone substitute covered by resorbable collagen membrane in simultaneous dental implants placement and to compare the ridge width at three levels (crestal, middle and apical) clinically (osteometer) and radiographically (CT) pre operatively and postoperatively. Materials and methods: This prospective study was conducted in teaching dental hospital in College of Dentistry of Baghdad University on (15) patients with (21) dental implant with insufficient bony support for simultaneous dental implants , this study extended from March 2013 to the end of December 2013. All patients were treated at the time of implantation by using a synthetic bone substitute covered by resorbable collagen membrane .All patients examined clinically by osteometer and radio graphics (CT) to assess ridge width and height and bone density. Results: Clinically and radiographically evaluation showed increasing of ridge width after 6 months of healing period at three levels: apical, middle and crestal, statistically, there were no significant differences between ridge width gain measured clinically and radio graphically and gender and age groups. In this study the success rate (95.24) % in (20) dental implant and only (1) dental implant was failed (4.76) % at age 47 years old. Conclusion: There was significant increase in ridge volume that augmented at the time of implantation to become sufficient width for support implant esthetically and functionally. This study revealed that there was no effect in gender and age on bone augmentation with synthetic bone substitute. Keywords: GBR, Simultaneous dental implant, osteometer, CT, ridge width and height and bone density.
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