Three-dimensional alveolar ridge augmentation combined with photobiomodulation therapy for post-traumatic bone loss: clinical protocol, case report, and evidence review

Post-traumatic alveolar ridge deficiencies often involve three-dimensional bone loss, making dental implant placement highly challenging. Guided bone regeneration techniques, combined with fixation devices, soft tissue substitutes, and adjunctive photobiomodulation therapy, have been proposed to enhance predictability and clinical outcomes. A 46-year-old female with severe alveolar bone loss, insufficient keratinized tissue, and maxillary sinus pneumatization following trauma was treated. Simultaneous three-dimensional ridge augmentation was performed using cortical cancellous Regen Allograft stabilized with bone plates and tenting screws. An open sinus lift was carried out with graft placement beneath the elevated Schneiderian membrane and coverage with a collagen membrane. Soft tissue management included palatal tissue mobilization and placement of acellular dermal matrix (Regen Allograft) under the flap. Postoperative photobiomodulation therapy was applied using an 808 nm diode laser (0.2 W, 4 J/cm²) to enhance soft and hard tissue healing. After six months of healing, six implants (IRES, volution, SVB) were placed under guided surgery, followed by screw-retained prosthetic rehabilitation. Clinical and CBCT examinations were performed during a 24-month follow-up period. CBCT evaluation at six months demonstrated sufficient horizontal and vertical bone regeneration, enabling successful placement of six implants with satisfactory primary stability. Soft tissue healing progressed uneventfully, with favorable tissue maturation and minimal postoperative discomfort. Prosthetic rehabilitation was completed successfully, and clinical and radiographic follow-up over 24 months revealed stable peri-implant bone levels, healthy peri implant soft tissues, satisfactory esthetic and functional outcomes, and no biological or mechanical complications. This case demonstrates that combining bone grafting with fixation devices, sinus augmentation, acellular dermal matrix, and photobiomodulation can successfully manage complex post-traumatic ridge deficiencies. The multidisciplinary approach provided predictable functional and esthetic outcomes.