3D bone augmentation using CAD/CAM technology, biomaterials
BioBrief - Major Bone Augmentation
The Situation
A 75-year old and systemically healthy female came to our attention presenting with absent mandibular second bicuspids and molars and requiring a fixed rehabilitation supported by implants as she refused a removable solution. The clinical and radiographic evaluation showed a relevant vertical and horizontal bone atrophy of such an extent that short or narrow implants were not considered a reliable option. The patient smoked <10 cigarettes per day.
The Approach
The main goal was to obtain a horizontal and vertical reconstruction of the deficient alveolar bone in order to allow safe and prosthetically-guided implant placement. Reconstruction was obtained by means of a customized titanium mesh (Yxoss CBR®) in association with a mixture of autologous bone chips harvested from the mandibular ramus and bovine bone mineral (Geistlich Bio-Oss®).
The customized mesh was stabilized with titanium screws and covered with a collagen membrane (Geistlich Bio-Gide®).
The Outcome
Post-operative recovery of this patient was uneventful (no complications such as dehiscence or late exposure of the customized mesh) with complete correction of the initial defect. The Yxoss CBR® allowed an easy and faster reconstruction thanks to the precision of the prefabricated mesh filled with autologous chips, Geistlich Bio-Oss® and Geistilch Bio-Gide®.
Keys to Success
- Precise pre-operative radiographic evaluation and accurate pre-visualization of the final shape of the customized mesh
- The Yxoss CBR® must be fixed with Titanium micro-screws
- Regeneration with autologous bone chips mixed with Geistlich Bio-Oss® granules
- Resorbable collagen membrane (Geistlich Bio-Gide®) in order to optimize the barrier effect
- It is mandatory not to load with removable prosthesis during healing
About the author
Prof. Matteo Chiapasco – Graduated in Medicine and specialized in maxillofacial surgery at the University of Milan, Italy. Professor, Unit of Oral Surgery, University of Milan; Associate Professor, Loma Linda University, Los Angeles, California, USA.
Dr. Grazia Tommasato – Graduated in Dentistry in 2013, specialized in Oral Surgery at the University of Milan magna cum laude. PhD student and a medical consultant of the Clinical Unit of Oral Surgery (“G. Vogel” Clinic, Milan).
