Reconstruction of Severely Atrophic Pre-maxilla Using Rhbmp-2 and Titanium Mesh For Dental Implants: A Case Report. - Reconstruction of Severely Atrophic Pre-maxilla Using Rhbmp-2 and Titanium Mesh For Dental Implants: A Case Report. - Open Access Pub

DOI10.14302/issn.2473-1005.jdoi-15-742 In order to achieve functional and esthetic oral rehabilitations, dental implants must be placed at an ideal tridimensional position in the alveolar bone. A clinical case is presented of a 49-year-old female with a severely resorbed pre-maxilla. Bone augmentation was conducted using the “tent pole” technique with human recombinant morphogenetic bone protein-2 embedded in an absorbable collagen sponge and deproteinized bovine bone. In addition, a titanium mesh was adapted over the graft to provide support. At 8 months post-op, a cone beam computerized tomography (CBCT) scan showed significant bone consolidation. An ideal pre-maxilla ridge with more than 14 mm of vertical and 10 mm of horizontal width was observed. Four dental implants were placed. Re-entry was 6 months later. Individual crowns were made to substitute the incisors, which were in function for the 1-year follow-up. The use of dental implants for oral rehabilitations has become a routine procedure in the practice in dentistry. An increasing number of fully and partially edentulous patients seek this type of rehabilitation for the advantage of being a fixed and conservative solution to the tooth loses. Dental implants must be planned and placed at the best tridimensional position in the alveolar process in order to restore masticatory and phonetic functions, in addition to esthetics. For this purpose, the treatment plan is governed primarily by the prosthetic design.1 A significant number of patients present with bone defects that do not allow a prosthetically driven implant placement due to lack of bone resulting from numerous etiologies, such as: periodontal disease, traumatic dental extraction and/or physiologic absorption.2 Autogenous bone grafts are considered the gold standard of augmentation materials for the treatment of oral and maxillofacial bony defects.3 The autogenous grafts shows advantages over the other graft types due to their ostegenic, osteoinductive and osteoconductive characteristics. This graft can be harvested from mandible, maxilla, tibia, cranial vault and iliac crest. However, the autogenous bone grafts require the need of a second surgical site, which increases postoperative morbidity, pain, sensibility alterations, scars and infections especially at the donor site. In addition, it incurs additional costs.4 To overcome these disadvantages, researches have strived to develop alternative materials to substitute the autogenous bone grafts. The human recombinant morphogenetic bone protein 2 (rhBMP-2) is a growth factor associated