Use of the CAD-CAM titanium scaffold Yxoss CBR® allows ideal bone regeneration and a faster and easier surgery.”

Combined horizontal and vertical regeneration using CAD-CAM titanium scaffold

Dr. Gian Maria Ragucci · Spain
 · Prof. Federioc Hérnandez-Alfaro · Spain
 · July 21, 2023

BioBrief - Major Bone Augmentation

The Situation

A 54-year old and systematically healthy male patient (ASA I) came to our attention presenting partial edentulism in the lower jaw and requiring a fixed and aesthetic rehabilitation, refusing any removable solution. The clinical and radiographic evaluation results in a significant bone atrophy both in vertical and horizontal component; which makes it impossible to place both conventional implants and short or narrow implants.


The Approach

The approach to solving the case was developed in two steps: first the bone reconstruction to restore the ideal anatomy, second the positioning of the prosthetically guided implants. For all this, we have chosen an individualized and customized regeneration technique using a CAD-CAM titanium scaffold (Yxoss CBR®) in conjunction with a mix of 60% autologous bone and 40% Geistlich Bio-Oss®, covered by a resorbable collagen membrane Geistlich Bio-Gide®. At 9 months, the titanium scaffold was easily removed and 3 prosthetically guided implants were placed, completely surrounded by bone. At 12 months, a free gingival graft was performed to re-establish the missing amount of keratinized mucosa. Finally, at 16 months, the final rehabilitation was carried out with a fixed prosthesis on implants.


The Outcome

The final resolution of the case was very satisfactory. There were no complications during all the procedures performed. The Yxoss CBR® allowed for easier reconstructive surgery and a significant reduction in surgical times, thanks to the precise dimensions of the scaffold. This resulted in a favourable postoperative situation for the patient and complications were prevented.

Keys to Success

  • The scaffold was fixed with 2 titanium micro screws
  • Substantially reduced surgery time vs. conventional, non-indivualized titanium meshes
  • Augmentation performed with a mix of 60 % autologous bone particles and 40 % Geistlich Bio-Oss®
  • Resorbable collagen membrane (Geistlich Bio-Gide®) in order to optimize the barrier effect

About the authors

Dr. Gian Maria Ragucci | Spain

Gian Maria Ragucci, DDS, MSc – Universitat Internacional de Catalunya (UIC), Barcelona
Dental degree at Universidad Europea de Madrid 2015, International Master in oral surgery at UIC, Barcelona 2018, PhD student at UIC, Barcelona 2018, EAO Certification program in implant dentistry 2018, EAO European prize in implant dentistry 2019


Prof. Federioc Hérnandez-Alfaro | Spain

Federico Hernández-Alfaro, MD, DDS, PhD, FEBOMS – Full professor & Chairman
Department of Oral and Maxillofacial Surgery, UIC, Barcelona, Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona