Several non-grafting and bone-grafting implant protocols have been reported in the literature, however implant treatment in severe maxillary bone atrophy remains a challenge.
Objectives: This clinical report describes clinically and histologically the use of demineralized bovine bone blocks for reconstruction of maxillary alveolar ridges to placement of dental implants.
Methods: A 43-year-old, female, non-smoking with good general health status presented as her primary complaint lacking of aesthetics and poor masticatory function. Severe atrophy of the maxilla was diagnosed through clinical and preoperative computed tomography scan examination. The treatment plan was developed for placement of 6 implants, after healing of the transversal bone augmentation which was carried out with bovine bone block grafts (OrthoGen; Baumer, São Paulo, Brazil). A maxillary prototype was used as a guide for this purpose. Eight months after bone grafting the reopening surgery was carried out. At this time, bone cores from the graft were removed with a trephine bur for histologic analysis. Next, the miniscrews were removed, and titanium implants (Neodent Sistema de Implantes Osseointegrados, Curitiba, Brazil) were placed. Six months after surgery for titanium implants placement, the reopening surgery and prosthetic rehabilitation were performed.
Results: During surgical procedures, well vascularized and incorporated bone blocks were observed. Histologically adhesion, growth and maturation of osteoblasts, as well as new osteoid tissue deposition directly onto the surface of the bone graft, were observed.
Conclusion: Although bone grafting procedures with autologous bone are the gold standard,often the use of bone substitutes presents the advantages of reducing discomfort and morbidity donor site to patients. Moreover it decreases operative trauma, surgical procedures and operative time.