Abstract: This case report describes the implant restoration of extended edentulous spaces in the aesthetic zone using an autogenous-heterogeneous bone mixture as the bone grafting material for guided bone regeneration (GBR) with titanium mesh, combined with keratinized tissue augmentation. The patient presented with a traumatic fracture of the anterior maxilla, horizontal alveolar bone loss, and loss of multiple consecutive teeth. Autogenous bone was mixed with deproteinized bovine bone mineral heterograft and implanted in the area of bone loss. Titanium mesh and a bioresorbable barrier membrane were placed labially. After six months, implants were placed under the guidance of a simple prosthetic guide. Keratinized tissue augmentation was performed before second-stage surgery. The final esthetic restoration was completed after 6 months of wearing the provisional denture. The treatment outcomes demonstrated that the use of an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh resulted in ideal bone augmentation, providing an optimal site for implant placement. The keratinized tissue augmentation procedure provided satisfactory clinical outcomes for the final aesthetic restoration. Therefore, we concluded that using an autogenous-heterogeneous bone mixture as grafting material for guided bone regeneration with titanium mesh is an effective method for increasing horizontal alveolar bone volume in the anterior region.

Key words: Implant in the esthetic zone, Guided bone regeneration (GBR), Autogenous bone, Titanium mesh, Keratinized tissue augmentation