BACKGROUND Resorption of the alveolar ridge often leaves insufficient bone volume. Very few studies have investigated the quantity and quality of bone formation in humans, following alveolar ridge augmentation, using autogenous bone and bovine bone mineral (BBM) under titanium mesh. METHODS Sixteen alveolar bone defects divided into two groups; control group with symphyseal autogenous bone covered by titanium mesh; and test group with symphyseal autogenous bone mixed with BBM in 1: 1 ratio and covered by titanium mesh. The outcomes were evaluated clinically, histologically, and histomorphometrically. RESULTS Clinical measurements showed that the horizontal bone gain was 3.44±0.54 mm and 2.88±0.57 mm, on average, for control group and test group, respectively. While graft absorption was 2.66±0.98 mm (43.62%) and 1.67±1.00 mm (36.65%), on average, for control group and test group, respectively. In the test group, BBM particles were still recognizable, on histologic analysis. They were surrounded completely or partly by newly formed bone. Clear signs of resorption of the BBM were found, with osteoclast cell noticed in the area. Histomorphometrically, the newly formed bone was 78.40%±13.97% and 65.58%±6.59%, whereas connective tissue constituted 21.60%±13.97% and 23.87%±4.79% for control group and test group, respectively. The remaining BBM particles occupied 10.55%±1.80%. All differences between the control and test groups were not significant (P>.05). CONCLUSIONS This investigation suggests that horizonal ridge augmentation with titanium mesh and autogenous bone alone or mixed with BBM are predictable and ridges were augmented even if mesh exposure occurs.