OBJECTIVES: This review aimed to evaluate the outcomes of ridge augmentation techniques and bio-materials for alveolar bone regeneration, addressing inconsistencies across studies. A decision tree is provided to guide clinicians in selecting optimal approaches for diverse clinical scenarios. DATA AND SOURCES: An extensive search was conducted across electronic databases, including PubMed, Scopus, and Embase, alongside dental implant and prosthodontics journal portals. Reference lists of relevant articles were also manually reviewed up to October 2024. STUDY SELECTION: Inclusion criteria were established to emphasize English-language human clinical trials investigating regenerative techniques and materials utilized for ridge augmentation prior to implant placement. CONCLUSIONS: Selecting defect-specific regenerative approaches is crucial for successful outcomes in alveolar bone augmentation. While autografts remain the gold standard, advancements in allografts, xenografts, synthetics, and biological enhancers are transforming the field. Distraction osteogenesis is also gaining prominence as a promising technique. Clinicians should leverage these innovations to tailor treatments to individual patient needs for optimal results. The decision tree developed categorizes alveolar bone defects and suggests tailored approaches based on anticipated resorption patterns. CLINICAL SIGNIFICANCE: Careful patient evaluation and tailored technique selection, combined with advancements in biomaterials and tissue engineering, are essential for achieving optimal outcomes in ridge augmentation, particularly for challenging vertical defects.