Abstract
Gingival recessions constitute serious limitations for effective interdisciplinary periodontal, orthodontic, and implant therapy. A proper bone morphology of the alveolar bone and soft tissues that cover it are interdependent. The regeneration procedures known to date are based on the use of autogenous bone, or its allogeneic, xenogeneic, or alloplastic substitutes. These substitutes are characterized by different osteogenesis potentials. No effective procedure for three-dimensional bone reconstruction for cases in which there is dentition with recessions has been described to date, especially in its vertical dimension. This article presents the patented method of the three-dimensional bone reconstruction of the anterior mandible with preserved dentition when using an allogeneic bone block, and also includes a case report with a 2-year follow-up as an example. Based on clinical observations, it was stated that the intended therapeutic effect was achieved. There was no recession, shallowing of the vestibule, signs of inflammation, or pathological mobility of the teeth in the area undergoing reconstruction. The radiographic images revealed the formation of a new layer of cortical bone on the vestibular side and a certain volume of cancellous bone. No radiological demarcation zone of brightening, which indicates an incomplete adaptation, integration, and reconstruction of the bone block, was found.
Highlights
Gingival recessions are a significant problem of an aesthetic nature, and constitute serious limitations for effective interdisciplinary periodontal, orthodontic and implant therapy—especially when they are accompanied by an advanced loss of bone [1,2]
In cases of an insufficient amount of soft tissues and an increased risk of the inability to close the wound without excessive tension of the flap, implementation of correction/augmentation procedures preceding the actual bone reconstruction surgery is recommended
Our observation of treatments with the use of an individualized threedimensional bone block allows us to distinguish the many advantages resulting from this method
Summary
Gingival recessions are a significant problem of an aesthetic nature, and constitute serious limitations for effective interdisciplinary periodontal, orthodontic and implant therapy—especially when they are accompanied by an advanced loss of bone [1,2].Correct bone morphology of the alveolar bone, as well as the soft tissues that cover it (periosteum and gingiva), are interdependent [3]. A lack of cancellous bone, considered as the primary developmental condition in some patients, or the effect of its pathological loss, results in a thin layer of compact bone in a given area. In such a case, due to the lack of a threedimensional stable base, there is a consistent loss of bone—even when the periosteum is preserved [3]. Due to the lack of a threedimensional stable base, there is a consistent loss of bone—even when the periosteum is preserved [3] In these cases, there is only an avascular base created by exposed surfaces of tooth roots for potential regeneration. There is a lack of adequate dimensions of the avascular base to conduct the subsequent implantation [5]
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