Alveolar Ridge Regeneration Using Flexible Allogeneic Laminar Bone for Implant Site Development: A Case Series

Background: Horizontal alveolar ridge deficiencies resulting from tooth loss, implant failure, trauma, or advanced ridge atrophy frequently require augmentation before prosthetically driven implant placement can be achieved. Flexible allogeneic cortical bone laminae have been introduced as biologic containment devices that also eliminate the need for titanium mesh or non-resorbable barrier membranes. Methods: Three patients presenting with horizontal ridge deficiencies were treated using guided bone regeneration (GBR) with flexible allogeneic laminar bone combined with particulate mineralized and demineralized cortical allografts. The laminar bone was adapted beneath full-thickness flaps to ensure semi-rigid containment of the graft material and maintenance of the regenerative space. Clinical and radiographic healing were evaluated using periapical radiographs and cone beam computed tomography (CBCT). Implants were placed following healing, and patients were followed up with for up to three years. Results: All treated sites demonstrated successful horizontal ridge augmentation with preservation of ridge contours and sufficient bone volume for implant placement. Primary implant stability of at least 35 Ncm was achieved in the documented cases. CBCT evaluation confirmed bone formation along the buccal aspect of the implants and maintenance of ridge dimensions. No graft collapse, membrane exposure, infection, or donor-site morbidity was observed. Long-term follow-ups demonstrated stable peri-implant hard- and soft-tissue conditions. Conclusions: Flexible allogeneic laminar bone used in combination with a particulate allograft appears to be a predictable and minimally invasive approach for horizontal ridge augmentation and implant site development. The technique offers effective space maintenance, favorable ridge contour preservation, and stable regenerative outcomes while reducing surgical morbidity associated with traditional augmentation procedures. This report demonstrates clinical feasibility and that larger prospective controlled studies with quantitative outcome assessments are needed to confirm these preliminary observations.