Surgical management of autogenous bone block graft exposure followed by prosthetic rehabilitation of thin residual ridge

Abstract

Autogenous bone block graft is the gold standard technique for alveolar bone augmentation. However, it is technique sensitive and associated with several complications. Exposure of block graft can affect the outcome of surgery and is challenging to manage. A patient diagnosed with Seibert Class III residual alveolar ridge was managed with autogenous bone block graft. Two dental implants were placed after obtaining sufficient ridge augmentation. The patient presented with exposure of bone block graft after implant placement. A full-thickness mucoperiosteal flap was elevated. Exposed bone was shaved and contoured using piezosurgery. A connective tissue graft with epithelial striation from palate was employed to cover the exposed graft and augment the keratinized tissue. Treatment resulted in complete coverage of block graft and gain in keratinized mucosal dimensions. Prosthetic rehabilitation using screw-retained 3 Unit Bridge was delivered. The results are sustained after 2 years, and the patient is being followed up.

Keywords

• autogenous bone block graft
• graft exposure
• piezosurgery
• ridge augmentation
• soft tissue augmentation
• subepithelial connective tissue graft