Vertical ridge augmentation using the modified shell technique--a case report.
OBJECTIVE
Vertical defects of the alveolar crest limit implant placements. Accordingly, hard tissue grafting is essential in a separate procedure before implant placement; however, the outcome of vertical bone augmentation is unpredictable.


METHODS
This case report describes a new approach to vertical hard tissue grafting using the modified autogenous shell technique. With the help of a bone mill, the bone graft was trimmed to a shell with a thickness of less than 1 mm and seeded to rebuild the vertical dimension of the alveolar ridge. The shell was fixated with titanium microscrews, and the vertical distance between the shell and the residual bone was filled with autogenous particulate bone.


RESULTS
Wound healing was uneventful. Corticalization was observed across the bone chips, and there was only a small vertical resorption of the shell. Two implants could be inserted above the alveolar nerve into the augmented bone.


CONCLUSIONS
The modified shell technique showed promising results for the reconstruction of vertical bone defects. This technique could decrease the need for bone grafts taken from the iliac crest.
Assistant Professor, Department of Prosthodontics, University of Munich, Munich, Germany; Private Practice in Oral Surgery, Cham, Germany. Electronic address: michael.stimmelmayr@med.uni-muenchende.
Michael
M
Stimmelmayr
Assistant Professor, Department of Prosthodontics, University of Munich, Munich, Germany.
Jan-Frederik
JF
Güth
Private Practice, Forchheim, Germany.
Markus
M
Schlee
Tenured Professor, Department of Prosthodontics, University of Munich, Munich, Germany.
Florian
F
Beuer
D000328:Adult; D064728:Alveolar Bone Grafting / Q000379:methods*; D016301:Alveolar Bone Loss / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001861:Bone Regeneration; D001863:Bone Screws; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery; D012189:Retrospective Studies; D060053:Transplant Donor Site / Q000601:surgery*; D014716:Vertical Dimension