Autogenous bone, with its osteogenic, osteoinductive, and osteo-conductive characteristics has been used for bone grafts with optimal integration into host tissues. For this reason, autogenous bone has been often considered the gold standard of bone regeneration material. However, the amount of autogenous bone that may be harvested is limited, and the harvesting procedure is traumatic.

Bone substitutes, including allografts, xenografts, and alloplasts have been used successfully as alternatives to autogenous bone grafts in ridge augmentation procedures.

In 2008, autogenous tooth bone graft (ATG) was introduced and used for the first time as a bone grafting material for GBR. The tooth contents are extremely similar to that of the alveolar bone. The enamel inorganic, organic, and water contents are 95 percent, 0.6 percent, and 4 percent, respectively. However, in the dentin, the percentages are 70 to 75 percent, 20 percent, and 10 percent, respectively. They are 65 percent, 25 percent, and 10 percent, respectively, when compared to the alveolar bone content.

The aim of this study is to compare ridge augmentation using autogenous bone block (ABB) with immediate implant placement and filling the generated gap with autogenous bone graft (ABG) or ATG, or ridge augmentation using xenograft bone block (XBB) with immediate implant placement and filling the generated gap with ATG.

Inclusion Criteria:

• Teeth with buccal bone destruction by periodontal disease and need extraction (horizontal or vertical bone defect);
• Absence of acute inflammation;
• Absence of uncontrolled systemic illness that would preclude implantation;
• Good dental and systemic healthy conditions;
• Patients were willing and able to return for multiple follow-up visits.

Exclusion Criteria:

• Patients with systemic illnesses,
• psychological abnormalities,
• para-functional habit,
• smokers or alcoholics,
• pregnant and lactating patients,
• patients undergoing or recently completed radiotherapy or chemotherapy,
• patients on drugs affecting the healing process,
• patients with endodontically treated teeth