Evaluation of Modified Shell Technique in 3D Ridge Reconstruction: A Clinical and Radiographic Study

Abstract

Introduction: As a result of tooth loss, alveolar ridge resorption sacrifices bone volume including bone width. In order to replace the lost dentition with implants functionally and esthetically, bone augmentation procedures are carried out. Materials and Methods: Fifteen patients were selected to treat mandibular alveolar ridge resorption with an autogenous block graft harvested using piezoelectric surgical tips and split into two shells using a diamond disk then fixated on the decorticated defective ridge. Particulate xenograft bovine bone was then inserted between the fixated shell and ridge, the second shell was used to roof the bone particles. Results: The modified shell technique could be an alternative to other ridge augmentation techniques. This study shows promising clinical and radiographic results that carry the advantages of being: safe and precise cutting using Piezoelectric tips, the statistical data showed a significant difference in 3D bone volume where no unfavorable complication was detected. Conclusion: The modified shell technique showed a reliable technique in cases of 3D ridge reconstruction since it holds the advantages of autogenous bone properties and the rigidity of the bone shells that maintain the space necessary for augmentation. The use of PRF can accelerate wound healing and minimize the risk of flap dehiscence as well as it can speed up bone formation.