Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report

Abstract

Background In terms of a highly atrophic maxilla, bone augmentation still remains very challenging. With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) for allogeneic bone blocks, a new method for the treatment of bone deficiencies was created. This case report demonstrates the successful use of two specially designed and CAD/CAM manufactured allogeneic bone blocks for a full arch reconstruction of a highly atrophic maxilla with an all-on-six concept. Case presentation We report the case of a 55-year-old male patient with a highly atrophic maxilla and severe bone volume deficiencies in horizontal and vertical lines. In order to treat the defects, the surgeon decided to use a combination of two allogeneic bone blocks and two sinus floor augmentations. The bone blocks were fabricated from the data of a cone beam computed tomography (CBCT) using CAD/CAM technology. After the insertion of the two bone blocks and a healing period of 7 months, six dental implants were placed in terms of an all-on-six concept. The loading of the implants took place after an additional healing time of 7 months with a screw-retained prosthetic construction and with a milled titanium framework with acrylic veneers. Conclusion The presented procedure shows the importance of the precise design of CAD/CAM manufactured allogeneic bone blocks for the successful treatment of a highly atrophic maxilla. Proper soft-tissue management is one of the key factors to apply this method successfully.

Techniques on vertical ridge augmentation: Indications and effectiveness

“…. 16,21,97,101,103,[120][121][122][123][124][125][126][127] Depending on the nature of the graft, the results provided have been heterogeneous, with the vertical bone gain ranging from 4.12 mm (95% confidence interval 3.11-5.13 mm) for autogenous bone block to 2.03 mm (95% confidence interval 1.88-2.18 mm) for allograft bone block according to a recent systematic review. 66 Also, when using autogenous bone, the choice of the technique seems to influence the results heavily, with worse results for onlay bone block (3.5 mm, 95% confidence interval 2.2-4.9 mm) than for the three-dimensional "shell technique" (2.0 mm, 95% confidence interval 1.9-2.2 mm).…”

Prefabricated CAD‐CAM scaffolds for management of oro‐antral communication: A case report and histological analysis

“…[15][16][17] Recent computer-aided design and computer-aided manufacturing (CAD/CAM) opened the horizon for new opportunities in biological applications. [18][19][20] In this case report, a custom-made CAD-CAM scaffold was fabricated using an allogenic bone block which was anatomically shaped to seal a large oro-antral communication. A dental implant was placed after 5 months of healing time and collected bone chips were histologically examined.…”

Relevant Properties and Potential Applications of Sericin in Bone Regeneration

“…However, the harvesting procedure may lead to donor site morbidity, and there are limitations on the available volume. Allografts and xenografts, obtained from human donors and animal species, respectively, bypass the issue of limited material availability [ 7 , 8 , 9 ]. However, they carry risks of immunogenicity, disease transmission, and may lack the osteoinductive properties found in autografts.…”