The growth in bone reconstructive surgery has been unsurpassed in recent decades. However, most bone regenerative products lack any potential for delivering site-specific morphologically driven augmentation. It was therefore the purpose of this study to evaluate the histological and clinical incorporation of a novel CAD CAM allogenic block bone graft for the reconstruction of complex 3- dimensional alveolar defects. In addition the clinical outcome of dental implants subsequently placed and loaded within these grafts was assessed with up to 5 years in function. Results demonstrated that 4 of the initial 17 blocks failed (23.5%). The remaining 13 blocks plus an additional two replacement blocks were fully or partially incorporated within the recipient bone site (79%). Of the 29 implants placed within the integrated blocks, no failures occurred with up to 5 years in function, with a recorded mean marginal bone loss by implant of -0.5mm.