title: Use of a modified shell technique for three-dimensional bone grafting: description of a technique.
abstract: BACKGROUND
  Defects of the alveolar crest often lead to three-dimensional bone loss after tooth extraction. Therefore, hard tissue grafting is required prior to implant placement. Different techniques have been described in the literature.
  
  
  METHODS
  In this case report three-dimensional hard tissue grafting was performed with a modified shell technique and autogenous bone harvested from the mandibular ramus. The shells were trimmed to a thickness of 1 mm and placed to recontour the ideal shape of the alveolar ridge. The shells were then fixed with micro titanium screws, and the gap between the shells and the alveolar ridge was filled with autogenous bone chips.
  
  
  RESULTS
  Wound healing was uneventful. Consolidation of the bone graft showed almost no resorption and the implant was placed into vital bone.
  
  
  CONCLUSIONS
  The described shell technique for rebuilding three-dimensional alveolar defects showed promising results and could be an alternative treatment to other hard tissue grafting techniques.
authors.affiliation: Department of Prosthodontics, University of Munich, Germany. michael.stimmelmayr@med.uni-muenchen.de
authors.forename: M
authors.initials: M
authors.lastname: Stimmelmayr
authors.forename: J-F
authors.initials: JF
authors.lastname: Güth
authors.forename: M
authors.initials: M
authors.lastname: Schlee
authors.forename: T N
authors.initials: TN
authors.lastname: Göhring
authors.forename: F
authors.initials: F
authors.lastname: Beuer
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology* / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008439:Maxillary Diseases / Q000209:etiology / Q000601:surgery; D014081:Tooth Extraction / Q000009:adverse effects; D055815:Young Adult