Long‐term stability of horizontal bone augmentation at implant sites

Horizontal bone augmentation is a fundamental surgical procedure in regenerative implant dentistry. In recent decades, this procedure has evolved, enabling clinicians to achieve predictable and stable horizontal bone augmentation that supports dental implant restorations. This narrative review summarizes the current literature on the biological mechanisms underlying bone regeneration and the key concepts of horizontal bone augmentation using various surgical techniques. A search of the electronic databases PubMed and Medline was conducted to gather scientific evidence regarding the surgical principles, biomaterials, soft tissue considerations, different methods of horizontal bone augmentation, the stability of regenerated bone, and the associated survival rates of implant restorations. The findings indicated that horizontal bone augmentation techniques could reliably increase bone width (ranging from 3 to 5 mm), over follow-up periods of 10 years or more. The long-term stability of this regenerated bone can be predictably attained by considering these four key parameters: (1) Careful case selection: A contained alveolar ridge defect in a non-smoking patient with optimal glycemic control and good oral hygiene. (2) Adherence to biologically sound surgical principles: This includes ensuring primary wound closure, maintaining adequate blood supply, creating and preserving space for augmentation and achieving overall stability of the surgical site during the healing phase. (3) Selection of appropriate biomaterials to facilitate effective bone regeneration. (4) Management of soft tissue through surgical interventions to create a stable wound during bone augmentation, as well as to maintain peri-implant bone health. This review presents clinical cases with long-term follow-up to illustrate the importance of these various aspects of bone augmentation in ensuring predictable long-term stability of regenerated bone.