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.