two groups of patients both have alveolar bone deficiency in anterior maxilla, one group will be subjected to khoury bone augmentation with conventional flap the other with vestibular shifted flap

The procedure begins with preoperative preparation, including patient positioning in a semi supine position with appropriate head support, induction of local anesthesia, and meticulous surgical site sterilization.

• Full thickness Vestibular flap and 2 horizontal releasing incision are made (Key Concept: The vestibular shifted flap provides additional flap length by translating vestibular mucosa coronally while preserving keratinized tissue and blood supply) in a group and conventional flap in the other group
• Flap elevation: Full thickness flap in the Donor site
• Using piezoelectric device, thin cortical bone blocks (1-1.5 mm thick) are harvested.
• Blocks are carefully shaped into flat "plates."
• The shell Graft placed, adapted and fixed with microscrews to restore desired horizontal dimension
• The space between the host bone and the fixed cortical plates is filled with bone particles.
• Tension free bilayered suturing

Inclusion Criteria:

• Adult patients with horizontal bone defects in anterior maxilla
• Mixed dentition age (21-75)
• Good periodontal health
• Non smokers
• Both genders males and females will be included

Exclusion Criteria:

• Uncontrolled systemic disease
• General contraindications to surgery.
• Patients participating in other studies, if the present protocol could not be properly followed.

This trial is considered a randomized single blind clinical trial due to:

• The participants will be blinded to the technique that will be used during the surgical procedure.
• The operator will not be blinded for both techniques during the surgical procedure as the two techniques are different.
• The outcome assessor cannot be blinded.