Exosomes, the smallest subset of extracellular vesicles, play a crucial role in cell signaling and communication throughout the body. Their regenerative potential has sparked tremendous interest, with over 5,000 articles on exosomes being published yearly, primarily focused on invitro and pre-clinical studies. However, to date, no study has investigated their use in humans for dental applications. In this first case report, horizontal ridge augmentation was performed utilizing a novel combination of bone allografts, platelet-rich fibrin (PRF), and a specialized subset of exosomes (Periosomes). Implants were placed at 3 months post-surgery, during which a core biopsy was taken for histological analysis. Additionally, cone-beam computed tomography (CBCT) scans were obtained at 1, 2, 3, and 6 months, revealing marked and progressive bone growth. To our knowledge, this study represents the first documented use of exosomes in human alveolar bone regeneration. This case highlights the promising potential of exosomes in regenerative dentistry, opening new avenues for their application in guided bone regeneration procedures.