Autogenous and Xenograft Bone Mix in Alveolar Ridge Reconstruction

Following a tooth extraction, the loss of alveolar bone is inevitable. As the site remodels, the alveolar ridge naturally shrinks in both height and width (Schropp et al., 2003). This loss of bone volume can make dental implant placement challenging, frequently requiring bone grafting procedures to rebuild the necessary foundation for the implant.Guided bone regeneration (GBR) stands as a leading strategy for repairing osseous defects. When employing particulate bone grafts, this approach typically depends on the application of barrier membranes to promote the regeneration of bone tissue (Retzepi \& Donos, 2010).Various regenerative approaches have been proposed to restore ridge width: among these, guided bone regeneration (GBR) using a combination of autogenous bone and xenogenic grafts has gained widespread acceptance due to its biological properties and ability to achieve stable dimensional augmentation (Urban et al., 2013).Historically, various methods have been implemented to enhance both the volume and structural integrity of newly formed bone. An ideal graft material must act as an effective osteoconductive scaffold, facilitating cellular ingrowth while preserving its dimensional stability. Although autogenous bone is still considered the gold standard for these procedures, it is prone to significant volumetric resorption as time progresses (Gulinelli et al., 2017).To counteract volume loss during the remodeling process, researchers have proposed combining autogenous bone with allogenic, xenogenic, or alloplastic substitutes (Chappuis et al., 2017). This composite grafting strategy is designed to enhance both the structural stability and overall quality of the augmented site, while simultaneously decreasing surgical morbidity by minimizing the volume of autogenous bone required for harvest (Mendoza-Azpur et al., 2019). Even though composite grafts are routinely employed in clinical practice, the ideal proportion of autogenous bone to xenogenic material in guided bone regeneration (GBR) protocols has yet to be definitively established.

Inclusion Criteria: 1. Age Range: Patients aged 20-60 years (Slagter et al., 2021). 2. Dentition Status: Partial edentulism in the posterior mandible involving the loss of two or more teeth. 3. Ridge Dimensions: Severely deficient alveolar ridge width (≤ 4 mm) paired with adequate residual vertical bone height (≥ 9 mm) (Thoma et al., 2017). 4. Systemic Health: Free from systemic diseases that could impair healing (Donos et al., 2015). 5. Inter-arch Space: Sufficient intermaxillary clearance (8-12 mm) to accommodate the definitive prosthetic components (Misch et al., 2005). 6. Oral Hygiene: Satisfactory oral hygiene status (Sälzer et al., 2020). 7. Compliance: Patient cooperative and willing to adhere to a 6-month post-operative follow-up regimen. Exclusion Criteria: 1. Tobacco Use: Current smokers (Chrcanovic et al., 2015). 2. Local Pathology: Presence of active pathological lesions (such as abscesses, cysts, or acute infections) at the surgical site (Atef et al., 2020). 3. Pregnancy: Pregnant patients. 4. Metabolic Status: Patients with uncontrolled diabetes. 5. Pharmacological Interferences: Patients taking medications that alter bone metabolism or soft tissue healing (e.g., systemic corticosteroids, bisphosphonates, or undergoing chemotherapy/radiotherapy).