Abstract
Background: The placement of implants in the posterior mandible with the vertical bone defect can be associated with inadequate crown height space. Therefore, the vertical bone reconstruction of these defects is often necessary, although this procedure is technically challenging. Methods: A 49-year-old patient attended a private dental office for rehabilitation of an atrophic posterior mandible. The clinical and tomographic findings show absence of teeth #36, #37, #46, #47, and #48 with severe atrophy. Vertical bone augmentation was performed by using the guided bone regeneration technique with pericardium resorbable membrane followed by placement of short implants. The free gingival graft was performed, and after three months, screw-retained lithium disilicate single ceramic crowns were manufactured. Results: After a 3-years follow-up, bone loss around the implants or presence of gingival inflammation was not observed, and the prosthesis adaptation was found to have no alteration either. Therefore, aesthetics, as well as masticatory and speech functions, were preserved. Conclusion: There was no bone loss around the implants. The association between vertically guided bone regeneration using pericardium resorbable membrane is an alternative technique, and it avoids complications related to non-resorbable membrane exposure. It was shown to be viable after a 3-year follow-up.
Highlights
The mandibular posterior region frequently shows threedimensional bone defects, demonstrating limitations during its rehabilitation mainly due to the presence of noble structures, such as the mandibular canal and inferior alveolar nerve
576 The Open Dentistry Journal, 2021, Volume 15 angiogenesis must reach a certain distance from native bone for the bone substitute to allow re-vascularisation and formation of the new bone [6]
Cone-beam computed tomography (CBCT) showed that the patient had a limited bone height in the region of teeth #46 and #47 with a distance of 3-4 mm between the bone crest and mandibular canal hindering the placement of implants (Fig. 2a)
Summary
The mandibular posterior region frequently shows threedimensional bone defects, demonstrating limitations during its rehabilitation mainly due to the presence of noble structures, such as the mandibular canal and inferior alveolar nerve. There is often a deficiency of the soft tissue in terms of quantity and quality in this region [1]. In three-dimensional bone defects, there is no bony wall, that is, without enough bone tissue to support and stabilise the reconstructive material and clot. For this reason, bone healing can become compromised since. The reconstruction of vertical bone defects in the posterior region of the mandible is considered one of the most complex defects to perform the GBR technique. The vertical bone reconstruction of these defects is often necessary, this procedure is technically challenging
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