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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

Maxillofacial Plastic and Reconstructive Surgery 2022³â 44±Ç 1È£ p.21 ~ 21
Pfaffeneder-Mantai Florian, Meller Oliver, Schneider Benedikt, Bloch Julius, Bytyqi Ditjon, Sutter Walter, Turhani Dritan,
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 ( Pfaffeneder-Mantai Florian ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Meller Oliver ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Schneider Benedikt ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Bloch Julius ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Bytyqi Ditjon ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Sutter Walter ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry
 ( Turhani Dritan ) - Danube Private University Faculty of Medicine and Dentistry Department of Dentistry

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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Bone block; Allograft; Maxillary atrophy; Maxillary augmentation; CAD/CAM

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