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Reconstruction of a Complex Anterior Maxillary Defect Using the Bone-to-Soft Tissue Technique: A Case Report.

Boris Baruch S Bernatskiy¹, Joseph Y Kan², Ekaterina A Zernitckaia²

¹Independent Researcher, Moscow, Russia.

Case Reports in Dentistry

|June 26, 2026

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This study presents a novel Bone-to-Soft Tissue (B2S) protocol for reconstructing severe alveolar defects using a combined tooth-bone-soft-tissue graft. This biologically driven approach offers a promising alternative for esthetic zone reconstruction when implants are not feasible.

Area of Science:

Dental surgery
Regenerative dentistry
Esthetic reconstruction

Background:

Alveolar defects in the esthetic zone present significant reconstruction challenges, especially with combined hard and soft tissue deficiencies.
Implant placement may be contraindicated due to patient age or anatomical limitations.
Biologically driven approaches for simultaneous dentoalveolar unit restoration are gaining traction.

Purpose of the Study:

To describe the clinical application of the Bone-to-Soft Tissue (B2S) protocol for alveolar defect reconstruction.
To evaluate the efficacy of transplanting a combined tooth-bone-soft-tissue complex in a young patient.

Main Methods:

A 17-year-old patient with traumatic maxillary central incisor loss and severe alveolar ridge deficiency was treated.

Keywords:

alveolar ridge reconstruction bone-to-soft tissue technique dental trauma rehabilitation dentoalveolar transplantation esthetic zone reconstruction tooth autotransplantation

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The Bone-to-Soft Tissue (B2S) protocol involved harvesting a dentoalveolar complex, including tooth, bone, and soft tissue.

The complex was adapted, stabilized at the recipient site, and followed by staged restorative management.

Main Results:

Successful integration of the transplanted dentoalveolar complex was achieved.
Preservation of soft tissue architecture and restoration of alveolar contour were observed.
Radiographic follow-up confirmed stable bone volume, with satisfactory esthetic and functional outcomes.

Conclusions:

Composite tooth-bone-soft-tissue transplantation using the B2S technique is a viable, biologically oriented option for specific esthetic zone reconstructions.
This approach is particularly relevant when conventional implant or regenerative methods are limited.
Further controlled studies are necessary to confirm long-term results and establish definitive clinical indications.