Vertical Guided Bone Regeneration with Mineralized Cancellous Bone Allograft in a Severe Anterior Maxillary Defect: A Clinical Report with 14-Year Follow-Up

Abstract

Purpose. To report the supracrestal bone regeneration of approximately 10 mm using solvent-dehydrated mineralized cancellous bone allograft and nonresorbable membrane in rehabilitation of unsuccessful implants in the anterior maxilla and stability of the regenerated bone at the 14th-year follow-up. Case Presentation. A 24-year-old female patient with a history of anterior dentoalveolar trauma resulting in the loss of upper left incisors and canine underwent rehabilitation several years ago with three implant-supported fixed prostheses. The prosthesis was both functionally and aesthetically inadequate, and the patient complained of gingival swelling, bleeding, and food impaction at the site of the implants. A staged approach for retreatment was planned, wherein the first surgical stage aimed at removing the existing implants and preparing the bone ridge and soft tissues for the augmentation procedure. The second stage was vertical ridge augmentation and simultaneous prosthetic-driven placement of two new implants at the sites of the left central incisor and canine. After nine months of uneventful healing, complete regeneration of the bony defect was achieved, and the new prosthetic rehabilitation satisfied both functional and aesthetic requirements. Conclusion. The therapeutic approach followed in the present case proved effective in achieving satisfactory functional and aesthetic results and in maintaining the stability of the regenerated bone at 14 years of follow-up.