Pilot Case Series of Lateral Ridge Augmentation Using a Collagenated Porcine-Derived Xenograft: Clinical, Histological, and Remodeling Outcomes

Background/Objectives: Horizontal alveolar ridge resorption following tooth loss often compromises implant placement and requires augmentation procedures to restore adequate bone volume. This pilot case series descriptively evaluated the clinical, radiographic, and histological outcomes of lateral ridge augmentation (LRA) using a collagenated porcine-derived xenograft combined with autogenous bone. Methods: Three consecutive partially edentulous patients presenting with severe horizontal ridge deficiency (residual bone width ≤ 4 mm) underwent LRA using a mixture of porcine-derived xenograft and autogenous bone covered with a resorbable collagen membrane. After a healing period of 3–5 months, core biopsies were harvested at implant placement and subjected to histological and histomorphometric analysis, including TRAP staining. Results: All sites healed uneventfully without intraoperative or postoperative complications. Radiographic evaluation demonstrated substantial horizontal bone gain, allowing placement of standard-diameter implants. Histological analysis revealed newly formed trabecular bone, residual graft material, and well-vascularized connective tissue, indicating active bone regeneration and biomaterial integration. TRAP-positive multinucleated giant cells (MNGCs) were observed at the biomaterial interface, suggesting ongoing remodeling. Long-term follow-up (mean 54.2 months) showed stable implant function without biological or mechanical complications. Conclusions: Within the limitations of this pilot case series, LRA using a collagenated porcine-derived xenograft combined with autogenous bone demonstrated preliminary favorable clinical, radiographic, and histological outcomes.