This clinical case aimed to achieve two main objectives. The first was to determine if the use of only calcium phosphosilicate bone graft as a regeneration material (with no autologous bone added) on a severe vertical and horizontal mandibular defect would allow enough bone to be obtained to enable the placement of dental implants. The second objective was to determine histologic characteristics of the regenerated site after a healing period of 10 months.

 

Vertical ridge augmentation is one of the greatest challenges for bone regeneration in implant dentistry. Intraoperative and postoperative complications are common.1-3

 

Achieving bone regeneration without osseous wall containment is biologically demanding.4,5

Covering the grafted area is also a challenge as the increased dimensions necessary for vertical ridge augmentation can make it difficult to achieve tension-free wound closure.6

 

 

Three therapeutic modalities have been proposed for vertical ridge augmentation:

 

distraction osteogenesis,7

 

bone blocks (either as onlays or inlays/interpositional grafts),8,9

 

and guided bone regeneration (GBR).10,11

 

Despite numerous studies having been done on all of these methods, the most suitable approach remains unclear.12 Block grafts are often described as the “gold standard” for severe atrophies13; however, advances in the field of biomaterials have favored the use of GBR, a procedure that is significantly less invasive than the first two.12

In the case here presented GBR for implant placement in a severe clinical situation was accomplished using only calcium phosphosilicate as a regeneration material.