Objectives: Horizontal ridge augmentation remains a clinical challenge due to limitations in terms of spatial maintenance, graft stability and predictability of new bone formation. The umbrella-screw tent technique provides mechanical stability for particulate grafts, while adjuvants such as hyaluronic acid (HA) and polynucleotides (PN) may enhance biological remodeling. Evidence for this compound in implant-related bone augmentation is still scarce. Material and methods: In a single patient with a knife-edge alveolar ridge, augmentation was performed in regions 34 to 36 using the umbrella-screw tent technique. The defect was grafted with deproteinized bovine bone mineral (DBBM) mixed with hyaluronic acid (HA) and polynucleotides (PN), supplemented with platelet-rich fibrin (PFR) and covered with a resorbable collagen membrane. After six months, two implants were installed, and a biopsy was obtained by trepanation for histological and histomorphometric analysis. Results: Healing occurred without compromise, with no signs of infection or graft exposure. Horizontal bone gain averaged 4.5 mm, corresponding to a relative Target Performance Index (TPI-h) of 75%. Histomorphometric analysis revealed a total mineralized fraction of 76.4%, consisting of 36.1% newly formed bone and 40.3% residual DBBM particles. The xenogeneic granules were completely integrated into mature bone, with no signs of inflammation or foreign body reaction. Conclusion: The case report illustrates that the combination of DBBM with HA and PN, stabilized by the umbrella-screw tent technique, can lead to significant new bone formation and favorable graft integration. Although limited by its single-case design, the case report provides preliminary insights into the synergistic potential of HA and PN as biological enhancers in bone augmentation, warranting further controlled studies.
Lubauer et al. (2026) studied this question.