Anterior Aesthetic Zone Reconstruction with Allogenic Bone Shell and Autogenous Bone Chips - An Evaluative Study

INTRODUCTION: Horizontal alveolar bone loss hinders dental implant placement. Reconstruction of alveolar deficiency is mandatory to establish an ideal foundation for implant-supported prosthetic restoration. The aim of this study is to evaluate the regenerated bone following anterior aesthetic zone reconstruction with allogenic bone shell and autogenous chips. MATERIALS AND METHODS: A total of 15 deficient sites in the aesthetic zone were treated using allograft bone shells, which were fixed away from the alveolar ridge using microscrews, and the created gap was filled with autogenous chips harvested intraorally using a bone scraper. RESULTS: Clinically, one patient experienced wound dehiscence in the second post-operative week, and the graft had to be removed one month postoperatively due to infection. Three patients experienced shell detachment six months later but that did not hinder the placement of an implant. Radiographically, there was horizontal bone gain that was statistically significant six months postoperatively. The mean apical bone gain was 2.64 mm (±0.99 standard deviation [SD]). The mean mid-level bone gain was 3.44 mm (±0.52 SD). The mean crestal bone gain was 2.36 mm (±0.85 SD). Histologically, vital trabecular bone tissue with osteocytes and osteoblasts was detected. Moreover, the presence of reversal lines indicated bone formation and remodelling after grafting. DISCUSSION: This technique generates sufficient bone tissue in previously horizontally deficient alveolar ridges for subsequent implant placement and omits the need for a second surgical site with its consequent morbidity. The low complication rate reported needs further modifications to extrapolate results.