الفهرس 
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Abstract
The objective of this study was to evaluate clinically and radiogrphically expansion of narrow edentulous ridges for flapless placement of immediately loaded dental implants using bone expansion system.
The patients in this study were selected from the outpatient clinic of the oral and maxillofacial surgery department, faculty of dentistry, Alexandria university, all patients had narrow mandibular ridge and they received 20 microdent dental implants.
All patients were operated upon under local anaesthesia using aseptic technique, the implants were placed flaplessly using tissue punch, ridge expansion was done using successive sizes of expanders from microdent expansion system and the implants were immediately loaded with provisional restoration and the final restoration was done one month postoperatively.
The patients were instructed to avoid trauma at the surgical site, Ice packs were provided and a soft diet was recommended for 7 days and they were evaluated clinically and radiographically using cone beam CT, and image J program using panoramic radiograph preoperatively and at one, three and six months postoperatively.
Clinical evaluation showed that pain, discomfort and swelling decreased throughout the first week, also there was statistically significant difference in gingival index of periimplant mucosa in first third and sixth months postoperatively where inflammation and bleeding decreased.
The probing depth didn’t decrease significantly from first to third month but there was statistically significant difference in probing depth between first and sixth months and third and sixth months.
Radiographic evaluation showed that bone density increased significantly post operatively from first to sixth month; also the increase in ridge width measured from cone beam CT was statistically significant.