https://pubmed.ncbi.nlm.nih.gov/38657218/
Romain Doliveux, Simon Doliveux. Int J Oral Maxillofac Implants. 2024;39(2):263-270. doi:10.11607/jomi.10322

Original title: Guided and Prosthetically Driven Bone Augmentation Using the Shell Technique and Allogeneic Cortical Plate: A Prospective Case Series

This new case series of 10 patients presents a simplified approach of the allogeneic shell technique with maxgraft^® cortico using digital technology. Based on pre-operative CBCT and intraoral scans, digital models of the cortical plates were designed depending on the anatomy of each defect and 3D-printed into patterns which were used to shape the allogeneic plates at the time of surgery. Additionally, 3D-printed tooth-supported guides were used to transfer the position of the digitally desined cortical plates into the defect for a prosthetically driven bone grafting procedure, as well as to offer a fixed support to hold the allogeneic plates when they were ready to be screwed into the predetermined position. All treated sites healed without complications. At the time of implant placement, an average horizontal bone gain of 5.4 ± 1.1 mm was achieved with minimal bone resorption of 0.2 ± 0.1. Stable conditions were confirmed on periapical radiographs taken at the 1 and 2 years follow-ups.

PURPOSE

To describe the use of digital technology to surgically guide the shell technique using allogenic cortical plates for a fully guided bone augmentation procedure.

MATERIALS & METHODS

A total of 12 horizontal bone grafting procedures were performed using the shell technique with allogenic cortical plates. All grafting procedures were deemed successful and allowed for ideal 3D implant positioning. Of the 12 bone grafting procedures, which used a surgical template to position the cortical plate, 3 required an adjustment to reposition the plate to a more ideal position.

CONCLUSIONS

Digital technology was used to create a surgical template to guide the shell bone grafting technique with allogenic cortical plates. All surgical templates offered a fixed support to hold the cortical allogenic plate in the preplanned position, offering a predictable, simplified, and accurate guided bone grafting procedure. Further studies on a larger population of patients are necessary to assess those results and to verify the treatment approach described in this study.