23 March 2021

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Personalized bone graft in severe mandibular atrophy.

Author: Dario Cianci

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The case describes a vertical mandibular elevation with a personalized bone graft that allows a fixed prosthetic rehabilitation on implant.

MATERIALS AND METHOD

The case describes a fixed prosthetic rehabilitation on implants in the presence of severe bone atrophy in the third quadrant.

In order to be able to position the implants in the area with severe bone atrophy, a customized bone graft is designed.

The realization of the same uses the DICOM files of a cone beam that allow the construction of the coupling with the holes for the fixing screws through a CAD software.

The graft is milled from solid and delivered together with a template that faithfully reproduces its shape.

It has the guide channels that allow you to create the invitations for the fixing screws with a special cutter.

The aim is to provide sufficient bone volume for a fixed prosthetic rehabilitation on implants.

10 months are expected for the osseointegration of the same, the matching between the optical impression and a new cone beam allows the construction of a surgical template.

This is produced in the studio with a simple 3d printer for the guided positioning of implant fixtures in zone 36, 37.

After two months from the implant positioning, the optical impression is taken with the CAD CAM method and the zirconium oxide prosthetic elements are then milled to be positioned.

RESULTS AND CONCLUSIONS

The association of the cone beam with modern CAD CAM techniques allows the customized production of bone grafts.

This method can be combined with other well documented ones such as autologous and heterologous bone grafts with membranes.

The possibility of previewing the operating field with the printed model of the jaw and bone graft proves to be a useful aid for the surgeon.

CLINICAL SIGNIFICANCE

The clinical case shows a modality of intervention in the presence of a severe mandibular atrophy resolved through a personalized bone graft.

It is an interesting, relatively unobtrusive path that digitization in the dental field can offer and which can therefore be combined with traditional methods.