Private Practice, Munich, Bavaria, Germany.
Department of Oral Surgery and Dental Emergency Care, Faculty of Health, School of Dentistry Witten/Herdecke University, North Rhine-Westphalia, Germany.
J Esthet Restor Dent. 2019 May;31(3):171-178. doi: 10.1111/jerd.12454. Epub 2019 Feb 12.
Various biomaterials have been successfully applied in alveolar bone regeneration, however, the reconstruction of extensive osseous defects remains challenging and is often unfeasible with granular grafting materials. Several studies have outlined allogenic bone blocks as valid alternative to autologous block grafting.
In this report, we demonstrate the regeneration of two large osseous defects in the maxilla with allogenic bone blocks made from human donor bone. The bone blocks were customized using the CAD/CAM technology in order to enable the insertion of four dental implants.
Both blocks perfectly matched the defect geometry, showed limited resorption, led to the formation of sufficient amounts of mineralized bone in both horizontal and vertical dimensions and enabled the installation of implants according to the treatment plan. The implementation of innovative technologies for individualization of allogenic bone blocks simplifies the restoration of complex and extensive osseous defects and poses great benefits for both practitioners and patients.
The here presented procedure demonstrates the successful regeneration of two extensive osseous defects in a patient suffering from hypodontia using two CAD/CAM manufactured allogenic bone blocks, rendering the procedure far less invasive as compared to guided bone regeneration carried out with autologous transplants. Furthermore, to the best of our knowledge, this is the first case report that radiographically demonstrates the new formation of a cortical bone layer following block grafting with solely cancellous bone blocks.
各种生物材料已成功应用于牙槽骨再生，但广泛的骨缺损的重建仍然具有挑战性，通常无法使用颗粒状移植物材料来实现。有几项研究概述了同种异体骨块作为自体骨块移植的有效替代方法。
在本报告中，我们展示了使用同种异体人供骨制成的骨块来再生上颌骨中的两个大的骨缺损。使用 CAD/CAM 技术对骨块进行定制，以便能够插入四颗牙种植体。
两个骨块都完美地匹配了缺损的几何形状，显示出有限的吸收，在水平和垂直方向都形成了足够数量的矿化骨，并且能够根据治疗计划安装植入物。个性化同种异体骨块的创新技术的应用简化了复杂和广泛的骨缺损的修复，为医生和患者都带来了巨大的益处。
本研究介绍的程序展示了使用两个 CAD/CAM 制造的同种异体骨块成功再生了一名患有缺牙症患者的两个广泛的骨缺损，与使用自体移植物进行的引导骨再生相比，该程序的侵入性要小得多。此外，据我们所知，这是首例报告，影像学显示仅用松质骨块进行骨块移植后新形成了皮质骨层。
