Bone Column Technique For Narrow Alveolar Ridge Implant

A 63-year-old female presented with missing right mandibular first premolar (tooth 44) due to caries extraction years prior. Clinical and CBCT evaluation revealed narrow alveolar ridge. The treatment plan included implant placement with simultaneous in-situ autogenous bone column augmentation. The patient’s medical history was unremarkable. Clinical examination revealed a knife-edged ridge (5 mm width, 11 mm height) with intact adjacent teeth (45, 47). CBCT confirmed insufficient buccal bone volume. Surgical steps included a crestal incision, harvesting a 3×7 mm autogenous bone column, and placing a implant (Astra EV 4.2×11 mm, 25 N stability). The bone column was fixed at the buccal concavity using a titanium screw (2.0×10 mm).Postoperative CBCT at 4 months demonstrated successful osseointegration and restored ridge contour. Final prosthesis delivery achieved healthy peri-implant tissues and functional occlusion. Traditional particulate graft materials demonstrate inferior mechanical properties that compromise their collapse resistance. The utilization of autologous bone columns as supportive structures effectively mitigates post-operative bone collapse. The in-situ bone column technique avoids secondary donor sites and achieves superior aesthetic results and long-term stability of the bone augmentation Combining bioactivity with mechanical stability, this technique offers an innovative approach for implant rehabilitation in edentulous areas with insufficient bone volume. It also combines functional rehabilitation with aesthetic preservation, offering a predictable alternative to GBR in complex cases.