Valdec Silvio, Bosshard Fabienne A, Patrizi Andrea, Naenni Nadja, Husain Adib Al-Haj
Int J Oral Maxillofac Implants. 2025 Jun 25;0(0):1-18. doi: 10.11607/jomi.11352.
Beta-tricalcium phosphate (β-TCP), a ceramic material renowned for its excellent biocompatibility, is widely used in oral tissue regeneration owing to its superior osteoconductive properties. This case report presents the surgical and prosthodontic management, along with a two-year clinical and radiological follow-up, of a patient-specific β TCP scaffold designed using computer-aided design and manufacturing (CAD/CAM) for the augmentation of a complex maxillary anterior alveolar ridge defect.
A 37-year-old male presented with a mispositioned implant in the maxillary anterior region, initially placed during adolescence. Ongoing alveolar ridge growth resulted in increased infraposition, exposed implant surface, and aesthetic concerns, requiring repeated prostheti corrections. Removal of the implant, followed by treatment using a patient-specific β-TCP scaffold, was performed to address both functional and aesthetic deficiencies. The scaffold was designed by means of CAD/CAM, providing a tailored solution for bone augmentation. Since the final restoration was planned without an implant-based rehabilitation, a resorbable magnesium screw was chosen as the fixation element to minimize the need for reintervention. Despite a buccal dehiscence that necessitated additional soft tissue grafting, the first year demonstrated excellent integration and successful prosthetic restoration. The two-year follow up still demonstrated successful clinical and aesthetic outcomes. However, radiological findings revealed ambiguous resorption patterns in the scaffold area, prompting concerns about potential complications.
This case highlights the benefits of using CAD/CAM-based β-TCP scaffolds for complex alveolar ridge augmentation, offering enhanced predictability and reduced perioperative technical challenges. Despite the complication of soft tissue dehiscence, the long-term clinical outcome was favorable. Further clinical research is necessary to assess the long-term effectiveness and possible limitations of β-TCP scaffolds in regenerative and reconstructive dentistry, particularly regarding resorption patterns and soft tissue integration. Close clinical monitoring is recommended to ensure optimal healing and prevent any adverse effects on the treatment outcome.
β-磷酸三钙（β-TCP）是一种以其优异的生物相容性而闻名的陶瓷材料，因其卓越的骨传导性能而广泛应用于口腔组织再生。本病例报告介绍了一名患者使用计算机辅助设计和制造（CAD/CAM）设计的定制β-TCP支架进行复杂上颌前牙区牙槽嵴缺损植骨的手术和修复治疗，以及为期两年的临床和影像学随访情况。
一名37岁男性患者，上颌前部植入物位置不当，该植入物最初于青春期植入。持续的牙槽嵴生长导致植入物位置下移、表面暴露以及美观问题，需要反复进行修复矫正。为解决功能和美观缺陷，先取出植入物，然后使用定制的β-TCP支架进行治疗。该支架通过CAD/CAM设计，为骨增量提供了定制解决方案。由于计划最终修复不采用基于种植体的修复方式，因此选择了可吸收镁螺钉作为固定元件，以尽量减少再次干预的需求。尽管出现了颊侧裂开，需要额外进行软组织移植，但第一年显示出良好的整合效果和成功的修复。两年随访仍显示出成功的临床和美学结果。然而，影像学检查结果显示支架区域的吸收模式不明确，引发了对潜在并发症的担忧。
本病例突出了使用基于CAD/CAM的β-TCP支架进行复杂牙槽嵴增量的益处，提高了可预测性并减少了围手术期的技术挑战。尽管出现了软组织裂开并发症，但长期临床结果良好。有必要进行进一步的临床研究，以评估β-TCP支架在再生和重建牙科中的长期有效性及可能存在的局限性，特别是关于吸收模式和软组织整合方面。建议密切进行临床监测，以确保最佳愈合并防止对治疗结果产生任何不利影响。
