Two Dimensional Ridge Augmentation in Post Traumatic Alveolar Bone Loss with Allograft and Implants Placement: A Step by Step Clinical Report and Review of the Current Evidence

Background:Alveolar ridge deficiencies resulting from trauma pose significant challenges in implant dentistry, especially when both vertical and horizontal bone loss coexist. The combination of guided bone regeneration techniques with allografts and fixation devices such as bone plates and tenting screws can improve predictability and clinical outcomes. Additionally, managing soft tissue deficits using acellular dermal matrix (ADM) and en-hancing healing with low-level laser therapy (LLLT) further contribute to successful reha-bilitation.Case Presentation:A 46-year-old female patient with a history of traumatic in-jury to the maxilla presented with severe alveolar bone loss, insufficient keratinized soft tissue, and pneumatization of the maxillary sinus. Initial ridge width was 1.8 mm with vertical bone height ranging from 2 to 5 mm in different areas. Simultaneous horizontal and vertical ridge augmentation was performed using cortical cancellous allograft pow-der fixed with allograft bone plates and tenting screws. An open sinus lift was performed in the posterior maxilla with graft placement beneath the elevated Schneiderian mem-brane and coverage with collagen membrane. Soft tissue management included palatal incision to mobilize keratinized tissue and application of acellular dermal matrix under the flap. Primary closure was achieved with a full-thickness flap and direct suturing using resorbable and non-resorbable sutures. Low-level laser therapy was applied postopera-tively to promote healing and reduce inflammation. Implants (IRES Swiss) were placed six months post augmentation in positions FDI 11, 21, 22, 24, 25, 26 with dimensions ranging from 3.3×8 mm to 3.7×10 mm. Healing abutments were connected six months af-ter implant placement. Twelve-month follow-up showed stable bone volume and soft tis-sue health with no complications.Conclusion:This case highlights the successful man-agement of complex post-traumatic alveolar defects through combined hard and soft tis-sue regenerative techniques, including the use of allografts, bone plates, tenting screws, ADM, sinus lift, and LLLT. The multidisciplinary approach yielded favorable clinical and radiographic outcomes over one year.