Vertical 3D Bone Reconstruction with Simultaneous Implantation: A Case Series Report

Abstract

Tooth loss generally leads to a corresponding loss of supporting bone structures, jeopardizing correct implant placement. Bone augmentation procedures facilitate reconstruction of the alveolar contours but lengthen treatment time by about 4 to 9 months. The aim of this case series report is to describe the short-term results of the combination of three-dimensional bone augmentation using the shell technique in conjunction with simultaneous implantation. A total of 10 patients who underwent autologous bone augmentation using the shell technique with simultaneous implantation were retrospectively examined. The shell technique is an augmentation procedure using thin cortical bone plates adapted to the buccal and oral walls of the defect to rebuild the contours of the alveolar ridge. The remaining spaces are filled with bone chips. Healing time before second stage surgery was 4 months. The vertical bone defect at the beginning (VD), the height of the vertical bone graft, resorption at the time of second-stage surgery (BR1) and 1 year after prosthetic rehabilitation (BR2), the total resorption between augmentation and 1 year (BRtot), and the vertical bone loss of the implant (VBL) were measured. VD was 3.1 mm. Values for BR1 and BR2 were 0.4 and 0.45 mm, respectively, resulting in a total bone loss of 0.85 mm of bone loss (BRtot). VBL was 0.45 mm 1 year after prosthetic rehabilitation. The simultaneous approach of vertical bone augmentation in the shell technique and implantation shows excellent results in bone reconstruction and stability up to 1 year after prosthetic reconstruction and can shorten treatment time by 4 to 9 months.

Alveolar ridge augmentation using the shell technique with allogeneic and autogenous bone plates in a split‐mouth design—A retrospective case report from five patients

“…The resulting accelerated vascularization in the container and the greater volume stability of the avascular cortical bone plate reduces bone resorption to under 10%, and so the alveolar ridge contour can be restored with a predictable outcome 6‐8 . The low resorption rates even allow simultaneous insertion of implants in case of vertical bone augmentation 9 . The short‐ and long‐term results after augmentation with the aid of the shell technique demonstrated low complication rates and excellent volume stability, even ten years after surgery 10 …”

Clinical evaluations of alveolar ridge preservation in compromised extraction sockets with cortical‐lamina anchoring technique: Case series study

“…A similar technique called bilamina cortical tenting grafting technique was used for reconstruction of vertical and horizontal alveolar ridge defects, where the vertical and horizontal bone gain was 5.70 ± 1.09 and 8.45 ± 0.87 mm, respectively 22 . Another study by Tunkel et al 23 using the shell technique showed excellent results in bone reconstruction, as 3‐dimensional bone regeneration using the shell technique is faster and shows lower resorption rates compared to augmentation procedures with compact cortical bone blocks and GBR. In the present study, the RARH gain was 6.92 ± 0.52 mm, and slight vertical and horizontal resorption was observed after a 3‐month healing period.…”

Multi-Layer Technique (MLT) with Porcine Collagenated Cortical Bone Lamina for Bone Regeneration Procedures and Immediate Post-Extraction Implantation in the Esthetic Area: A Retrospective Case Series with a Mean Follow-Up of 5 Years

“…The recently developed 0.7 mm thickness Rigid Lamina undergoes a process of superficial semi-decalcification (about 50% as compared to Lamina soft), therefore increasing its consistency, typical of the cortical bone tissue [ 29 , 30 ]. It may represent a viable alternative to autogenous cortical bone plates in the reconstruction of three-dimensional crestal defects with the shell technique [ 31 ].…”