Clinical and Radiographic Evaluation of Three Different Modalities for Management of Distal Extension Atrophied Mandibular Ridge: A One Year Prospective Study

Nine patients selected for this study with mandibular free end saddle and atrophied posterior ridge according to treatment options all patients will be divided randomly into 3 groups: * Group A: included three participants who will receive implant retained partial overdentures * Group B: included three participants who will receive short implants supported fixed prosthesis * Group C: included three participants who will receive long implant supported fixed prosthesis after ridge augmentation. * For Group A: Implant retained partial overdenture The implants will be inserted in first premolar areas and partial overdenture will be connected with implant by locator attachment. * For Group B: Short implant supported fixed prosthesis The implants will be inserted in first premolar, second premolar, and first molar areas without any ridge augmentation and the implant will be connected by fixed prosthesis * For group C: Long implant supported fixed prosthesis after ridge augmentation The implants will be inserted in first premolar, second premolar, and first molar areas with ridge augmentation by using Khoury technique17 and the implants will be connected by fixed prosthesis * Clinical evaluation will be made in terms of: * Gingival Index (GI) * Plaque Index (PI) * Pocket Depth (PD) * Width of Keratinized Mucosa (KM) * Implant Stability (ISQ). * Radiographic evaluation will include mandibular residual ridge resorption using the proportional area measurements. evaluation periods will be performed at time of insertion T(0), 6 months after insertion T(6), 12 months after insertion T(6)