Custom allogeneic block graft for ridge augmentation: Case series.

Abstract

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 6months 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.