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Prof. Matteo Chiapasco & Dr. Grazia Tommasato

University of Milan, Milan, Italy

Clinical case description:

3-D bone augmentation using a CAD/CAM customized titanium mesh in conjunction with autogenous bone and bovine bone mineral granules

A 75-year old and systemically healthy female came to our attention requiring a fixed rehabilitation in the bilateral mandibular edentulous areas, from teeth 35 to 38 and from 45 to 48. The clinical and radiological evaluation showed vertical and horizontal bone atrophies. Based on a computed tomography of the defect (CBCT) carried out before the surgical procedure with the aid of a radiopaque diagnostic template, DICOM scans of the three-dimensional models are reproduced in a very precise way. This makes it possible to produce a precise and accurate three-dimensional titanium scaffold which on its outer part represents the final shape/profile of the new and ideal alveolar ridge, while in the inner part containing and stabilizing the grafting material. This latter is generally represented by a mixture of autogenous bone chips and bovine bone mineral. The mesh was covered with a Geistlich Bio-Gide® in order to optimize the barrier effect.