BACKGROUND: The horizontally insufficient posterior mandibular ridge frequently restrains dental implant insertion. PATIENTS AND METHODS: A modified ridge split procedure was innovated to separate, convey laterally, and fix the buccal cortical plate in 20 patients with posterior horizontal mandibular alveolar deficiency. Meanwhile, the intercancellous space was obliterated with autogenous bone particulates for the test group patients and Anorganic bone bovine mineral (ABBM) for those of the control group. Following a comparison of the horizontal bone gain and the histomorphometric bone area percent among both groups after 6 months of graft consolidation, 40 implants were inserted during the second surgical stage. RESULTS: All of the grafts were consolidated. A statistically insignificant difference was found between the control group's mean 6-month postoperative horizontal bone width of (8.10 +/- 0.83) and that of the study one of (7.90 +/- 0.77). The control group's mean bone gain was recorded (4.76 +/- 0.81) versus (4.63 +/- 0.78) for the study group, with a statistically insignificant difference. Both groups showed histological evidence of a moderate number of osteoblasts, mature trabecular bone, and lamellae encircling large fatty marrow spaces. A statistically significant difference (p = 0.021) was found between the control group's mean bone area percentage of new bone formation (38.83% +/- 1.17%) and that of the study group (34.40% +/- 3.71%). CONCLUSION: The modified ridge split with either autogenous or (ABBM) graft was deemed reliable for reconstructing the horizontally deficient posterior alveolar ridge with appropriate volumetric stability and bone quality. TRIAL REGISTRATION: The study was registered on www. CLINICALTRIALS: gov (Registration #: NCT05286541).
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