Vertical bone augmentation of the posterior mandible followed by delayed implant placement and restoration remains a clinical challenge in dentistry. Commonly, a 2- stage approach is performed where first, a grafting procedure is performed with a typical xenograft/autograft mixture and an expected healing period of 9 months. Only thereafter can implant placement and restoration accomplished with a total treatment time upwards of 1-1.5 years. In the present case report, a novel approach that combines three-dimensional guided implant planning/surgery via digital software, the use of novel atelo-collagen based xenografts/membranes with improved biocompatibility, and immediate implant placement with simultaneous vertical guided bone regeneration (GBR) is described where the patient treatment protocol was significantly reduced. Highlighted within this case report is the effective use of guided surgery via digital software, as well as the use of biomaterials that feature atelo-collagen. Since xenografts are typically devoid of all collagen and growth factor content, the recent development of natural bovine bone mineral containing atelo-collagen type I have been proposed as grafts with greater biocompatibility, thus favoring optimized bone regeneration. This article describes the protocol in detail and emphasizes the necessary requirements to optimize bone regeneration in a predictable manner.
Ferdinando D'Avenia and Richard Miron