A patient with missing #44, #45 and #46 tooth was presented in the clinic. The evaluation of the initial clinical situation revealed strong atrophic ridge with the need for bone augmentation prior to implant placement. A customized allogenic bone block (maxgraft^® bonebuilder) was planned and designed according to the defect. The block was fixated to the site with titanium screws after bone decortation, and covered with a collagen membrane. The flab was subsequently closed and the success of the procedure was confirmed with CBCT scans directly after. After 6 months, a second-stage implantation was carried out. Upon reentry, maxgraft^® bonebuilder showed good integration in the bone and high vascularization. The titanium screws were removed and two implants were placed. Additionally, bone augmentation with autologous bone chips was performed to ensure sufficient bone volume for implant stability. Finally, after implant uncovering and placement of the final prosthetics almost no crestal bone resorption was demonstrated with stable outcomes. After implant uncovering and placement of the final prosthetics, the case demonstrated minimal crestal bone resorption and stable clinical outcome.

According to Dr. Faust, in cases of highly atrophic mandibles, the use of CNC-milled allogenic bone blocks is his preferred method for bone augmentation. The precise fit of the block reduces operation time, and with a slowly resorbing collagen membrane and soft tissue management, tension-free wound closure is achieved, minimizing the risk of block exposure.