Vertical Ridge Augmentation Using the Modified Shell Technique—A Case Report

Abstract

Vertical defects of the alveolar crest limit implant placements. Accordingly, hard tissue grafting is essential in a separate procedure before implant placement; however, the outcome of vertical bone augmentation is unpredictable. This case report describes a new approach to vertical hard tissue grafting using the modified autogenous shell technique. With the help of a bone mill, the bone graft was trimmed to a shell with a thickness of less than 1 mm and seeded to rebuild the vertical dimension of the alveolar ridge. The shell was fixated with titanium microscrews, and the vertical distance between the shell and the residual bone was filled with autogenous particulate bone. Wound healing was uneventful. Corticalization was observed across the bone chips, and there was only a small vertical resorption of the shell. Two implants could be inserted above the alveolar nerve into the augmented bone. The modified shell technique showed promising results for the reconstruction of vertical bone defects. This technique could decrease the need for bone grafts taken from the iliac crest.