Xeno-Hybrid Composite Scaffold Manufactured with CAD/CAM Technology for Horizontal Bone-Augmentation in Edentulous Atrophic Maxilla: A Short Communication




Appl. Sci. 2020, 10, 2659; doi:10.3390/app10082659


M. P. Cristalli, G. La Monaca, N. Pranno , S. Annibali , G. Iezzi, and I. Vozza


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The present short communication described a new procedure for the reconstruction of the
horizontal severely resorbed edentulous maxilla with custom-made deproteinized bovine bone block,
fabricated using three-dimensional imaging of the patient and computer-aided design/computer-aided
manufacturing (CAD/CAM) technology. The protocol consisted of three phases. In the diagnosis and
treatment planning, cone-beam computed tomographic scans of the patient were saved in DICOM
(digital imaging and communication in medicine) format, anatomic and prosthetic data were imported
into a dedicated diagnostic and medical imaging software, the prosthetic-driven position of the
implants, and the graft blocks perfectly adapted to the residual bone structure were virtually planned.
In the manufacturing of customized graft blocks, the CAD-CAM technology and the bovine-derived
xenohybrid composite bone (SmartBone® on Demand – IBI SA – Industrie Biomediche Insubri SA
Switzerland) were used to fabricate the grafts in the exact shape of the 3D planning virtual model.
In the surgical and prosthetic procedure, the maxillary ridge augmentation with custom-made
blocks and implant-supported full-arch screw-retained rehabilitation were performed. The described
protocol o ered some advantages when compared to conventional augmentation techniques. The use
of deproteinized bovine bone did not require additional surgery for bone harvesting, avoided the
risk of donor site morbidity, and provided unlimited biomaterial availability. The customization
of the graft blocks reduced the surgical invasiveness, shorting operating times because the manual
shaping of the blocks and its adaptation at recipient sites are not necessary and less dependent on the
clinician’s skill and experience.


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