The aim of the study was to compare efficacy of autogenous onlay and inlay grafts for anterior maxillary horizontal ridge augmentation.

Autogenous block graft has been used as onlay thin cortical shell and cortico-cancellous particles. The thin cortical shell acts as an autogenous biological membrane that will resist resorption and stabilize the small pieces of particulate bone. The bone block is screwed-in at a distance from the recipient site by means of titanium bone screws, and then the free space under the shell is filled with the particulate bone.

The resultant augmentation somehow resembles an iliac graft, with thick internal cancellous bone and a thin external cortical layer. This leads to an ideal graft, with a high regenerative capacity comparable to iliac bone and a stable regenerated volume with optimum osseointegration potential close to that of mandibular block grafts.

Interpositional grafts have been successfully established in restoring vertical bone height . However much less evidence is present on its use for horizontal augmentation. It is the purpose of this study to assess the efficacy of autogenous onlay corticocancellous block grafts for anterior maxillary horizontal ridge augmentation as compared to onlay block grafts.

Inclusion Criteria:

1. Patients with missing upper anterior tooth / teeth with horizontal ridge dimension range from 2 to 5 mm (measured 2mm below alveolar crest).
2. Adequate vertical height.
3. Having good oral hygiene.
4. being healthy, with no systemic diseases that might contraindicate receiving a dental implant
5. Patients were able to comply with the follow-up and maintenance program

Exclusion Criteria:

1. Presence of local infection or lesions at site of interest.
2. Dental history of bruxism, or other parafunctional habits.
3. Uncooperative patients.
4. Current chemotherapy or radiotherapy.
5. Patients with aggressive periodontal disease