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

Reconstruction of alveolar defects in the esthetic zone remains challenging, particularly when both hard- and soft-tissue deficiencies coexist or when implant placement is contraindicated due to age-related or anatomical factors. Biologically driven approaches aiming to simultaneously restore the dentoalveolar unit have gained increasing interest.

This case report describes the clinical application of a Bone-to-Soft Tissue (B2S) protocol involving transplantation of a combined tooth-bone-soft-tissue complex in a 17-year-old patient presenting with traumatic loss of a maxillary central incisor and severe alveolar ridge deficiency. The surgical procedure included harvesting of the dentoalveolar complex, adaptation to the recipient site, stabilization, and staged restorative management.

Stable integration of the transplanted complex was achieved, with preservation of soft-tissue architecture and restoration of alveolar contour. Radiographic follow-up confirmed maintenance of bone volume, whereas clinical outcomes demonstrated satisfactory esthetic and functional rehabilitation.

Composite tooth-bone-soft-tissue transplantation within the B2S technique may represent a biologically oriented alternative for selected cases of esthetic zone reconstruction, particularly when conventional implant or regenerative approaches are limited. Further controlled studies are required to validate long-term outcomes and define clinical indications.