This research is designed to evaluate and compare the clinical and radiographic outcomes of bovine bone graft (Medpark) versus extended sticky bone used for horizontal augmentation of atrophied esthetic area of maxillary ridge associated with simultaneous implant placement.

Patient selection This study will involve sixteen implants inserted in patients with missing upper tooth / teeth in the esthetic zone accompanied by horizontal alveolar ridge resorption, seeking future tooth replacement. The patients will be selected from the Outpatient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University

Inclusion Criteria:

1. Patient aged 18-45 years.
2. Cooperative patient with high motivation and acceptable oral hygiene.
3. Maxillary narrow ridge in the esthetic zone that needed horizontal bone augmentation. (Class I Siebert classification). (22)
4. No deep undercut at the ridge in the buccal aspect.
5. The presence of enough keratinized gingiva(≥3mm).(23)
6. Sufficient inter-arch space to accommodate the future prosthesis. (24)
7. Patients able to comply with the required recall visits.

Exclusion criteria:

1. Local and / or systemic conditions that contraindicate the placement of dental implant or surgery
2. Smokers
3. Pregnancy.
4. Parafunctional habits, including bruxism and clenching.

Inclusion Criteria:

• Patient aged 18-45 years, Cooperative patient with high motivation and acceptable oral hygiene, maxillary narrow ridge in the esthetic zone that needed horizontal bone augmentation. (Class I Siebert classification) (24),No deep undercut at the ridge in the buccal aspect, The presence of enough keratinized gingiva(≥3mm).(25), sufficient inter-arch space to accommodate the future prosthesis. (26) , and Patients able to comply with the required recall visits.

Exclusion Criteria:

• Local and / or systemic conditions that contraindicate the placement of dental implant or surgery, smokers, pregnancy and parafunctional habits, including bruxism and clenching.