Semmelweis University

Usability and Tissue Stability of CAD/CAM Prefabricated Allogenic Bone Blocks for the Reconstruction of Severe Bone Defects in the Aesthetic Zone of the Maxilla

Oliver Blume

Clinical Medicine

Dr. Reusz György

SE Semmelweis Szalon

2023-11-14 09:00:00

Dental Research

Dr. Varga Gábor

Dr. Windisch Péter

Dr. Huszár Tamás

Dr. Sass Tamás

Dr. Joób-Fancsaly Árpád

Dr. Körmöczi Kinga

Dr. Piffkó József

Bone grafting and bone reconstruction is a surgical procedure with the goal of replacing missing or resected bone material. Especially in the fields of maxillofacial and oral surgery bone grafting techniques and materials have been improved significantly during the past years and decades. The reason for this progress in research and development is the necessity of sufficient bone when it comes to dental implantation. Even though there is plenty of literature of the successful implantation of allogenic bone materials for the reconstruction of bone defects randomized controlled studies with a large number of patients are still rare to date. The main objective of this thesis is to evaluate the usability of CAD/CAM prefabricated allogenic bone blocks for the reconstruction of maxillary bone defects in the esthetic zone, based on a retrospective cohort study. In total 23 patients who presented with several bone defects in the esthetic zone in the upper jaw were reconstructed with customized allogenic CAD/CAM bone blocks, treated with 39 dental implants and evaluated. In this study a new digital technology to monitor volume changes during the healing process, using Slicer and coDiagnostiX was utilized. The result of the study was that customized allogenic CAD/CAM bone blocks are suitable as a reliable bone graft for the reconstruction of severe maxillary bone defects. Clinical, radiological and histological outcomes in the patients showed a successful reconstruction without need of re-augmentation. The resorption rates of the allogenic CAD/CAM blocks were with approximately 29% similar to autologous bone blocks. All patients offered anatomical requirements for successful implantations with a very small rate of complications. The digital volume rendering software Slicer and coDiagnostiX showed to be practicable and reliable to measure volume changes of hard tissue. The coherence of the two different independently used measuring methods validated their reliability. Considering the results of the study combined with the fact, that the use of CAD/CAM prefabricated allogenic bone blocks is lacking any kind of donor morbidity, indicates that their use is a serious alternative to use of autologous bone blocks for the reconstruction of severe defects of the alveolar crest.