Maxillofacial Plastic and Reconstructive Surgery (May 2022)

Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report

  • Florian Pfaffeneder-Mantai,
  • Oliver Meller,
  • Benedikt Schneider,
  • Julius Bloch,
  • Ditjon Bytyqi,
  • Walter Sutter,
  • Dritan Turhani

DOI
https://doi.org/10.1186/s40902-022-00351-9
Journal volume & issue
Vol. 44, no. 1
pp. 1 – 8

Abstract

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Abstract Background In terms of a highly atrophic maxilla, bone augmentation still remains very challenging. With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) for allogeneic bone blocks, a new method for the treatment of bone deficiencies was created. This case report demonstrates the successful use of two specially designed and CAD/CAM manufactured allogeneic bone blocks for a full arch reconstruction of a highly atrophic maxilla with an all-on-six concept. Case presentation We report the case of a 55-year-old male patient with a highly atrophic maxilla and severe bone volume deficiencies in horizontal and vertical lines. In order to treat the defects, the surgeon decided to use a combination of two allogeneic bone blocks and two sinus floor augmentations. The bone blocks were fabricated from the data of a cone beam computed tomography (CBCT) using CAD/CAM technology. After the insertion of the two bone blocks and a healing period of 7 months, six dental implants were placed in terms of an all-on-six concept. The loading of the implants took place after an additional healing time of 7 months with a screw-retained prosthetic construction and with a milled titanium framework with acrylic veneers. Conclusion The presented procedure shows the importance of the precise design of CAD/CAM manufactured allogeneic bone blocks for the successful treatment of a highly atrophic maxilla. Proper soft-tissue management is one of the key factors to apply this method successfully.

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