Private practice, Rochester, New York, USA.
Division of Graduate Periodontics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA.
Clin Adv Periodontics. 2023 Jun;13(2):94-101. doi: 10.1002/cap.10183. Epub 2021 Oct 6.
Alveolar bone deficiency is a common postextraction sequela that adversely affects implant placement. Therefore, ridge augmentation is often required to obtain proper bone quantity and quality for restoratively driven implant placement. This case series describes the successful horizontal and vertical alveolar ridge augmentation using custom-fabricated allogeneic block bone grafts.
Two healthy partially edentulous patients presented to private practice seeking dental implant treatment. Initial clinical examination and cone-beam computed tomography (CBCT) radiographic analysis showed moderate to large horizontal ridge defects. Treatment options were discussed for alveolar ridge augmentation and the patients elected to undergo the custom allogeneic block graft procedure to regenerate the atrophied alveolar ridges. The CBCT scan in conjunction with computer-aided design/computer-aided manufacturing (CAD/CAM) technology was used to fabricate customized allogeneic block grafts based on alveolar ridge topography. The custom allogeneic block graft allowed less surgical time and decreased postoperative morbidity. The grafted area was allowed 6 months of healing time. Follow-up radiographs showed the stability of the graft followed by dental implant placement. The dental implants were functionally loaded, and successful implant esthetics and function achieved.
Custom allogeneic block grafts could provide a promising innovative method for optimal ridge augmentation. Why are these cases new information? Less invasive procedure as an alternative conventional two-stage block augmentation. More predictable outcome due to customized block graft. What are the keys to successful management of these cases? It is important determining the type of bone defect. Vertical and horizontal bone loss. Primary closure. What are the primary limitations to success in these cases? Limited data from prospective clinical trials documenting the effectiveness of custom allogeneic block grafts. Limited data are available to confirm accuracy of the CAD/CAM process. Passive flap closure is needed.
牙槽骨缺损是拔牙后常见的后遗症，会对种植体的植入产生不利影响。因此，为了获得可用于修复驱动种植体植入的适当骨量和质量，通常需要进行牙槽嵴增量。本病例系列描述了使用定制异体块状骨移植物成功进行水平和垂直牙槽嵴增量的情况。
两名健康的部分缺牙患者到私人诊所寻求牙种植治疗。初步临床检查和锥形束计算机断层扫描（CBCT）影像学分析显示存在中度至大量的水平牙槽嵴缺损。讨论了牙槽嵴增量的治疗选择，患者选择接受定制异体块状移植物程序，以再生萎缩的牙槽嵴。CBCT 扫描与计算机辅助设计/计算机辅助制造（CAD/CAM）技术结合使用，根据牙槽嵴形态制造定制异体块状移植物。定制异体块状移植物允许更少的手术时间和减少术后发病率。移植物区域允许 6 个月的愈合时间。随访 X 光片显示移植物稳定，随后进行牙种植体植入。牙种植体被功能性加载，成功实现了种植体的美观和功能。
定制异体块状移植物为最佳牙槽嵴增量提供了一种有前途的创新方法。为什么这些病例是新信息？作为传统两阶段块状增量的替代方法，手术侵袭性更小。由于定制块状移植物，结果更可预测。成功管理这些病例的关键是什么？确定骨缺损的类型很重要。垂直和水平骨量丢失。一期闭合。这些病例成功的主要限制是什么？前瞻性临床试验记录定制异体块状移植物有效性的有限数据。CAD/CAM 过程的准确性可用数据有限。需要被动瓣闭合。
