Beta-Tricalcium Phosphate (β-TCP) for Customized Bone Regeneration (CBR) in the Aesthetic Area of the Maxillary Anterior Alveolar Ridge.

Abstract

Purpose: Beta-tricalcium phosphate (β-TCP), a ceramic material renowned for its excellent biocompatibility, is widely used in oral tissue regeneration owing to its superior osteoconductive properties. This case report presents the surgical and prosthodontic management, along with a two-year clinical and radiological follow-up, of a patient-specific β TCP scaffold designed using computer-aided design and manufacturing (CAD/CAM) for the augmentation of a complex maxillary anterior alveolar ridge defect.

Material and methods: A 37-year-old male presented with a mispositioned implant in the maxillary anterior region, initially placed during adolescence. Ongoing alveolar ridge growth resulted in increased infraposition, exposed implant surface, and aesthetic concerns, requiring repeated prostheti corrections. Removal of the implant, followed by treatment using a patient-specific β-TCP scaffold, was performed to address both functional and aesthetic deficiencies. The scaffold was designed by means of CAD/CAM, providing a tailored solution for bone augmentation. Since the final restoration was planned without an implant-based rehabilitation, a resorbable magnesium screw was chosen as the fixation element to minimize the need for reintervention. Despite a buccal dehiscence that necessitated additional soft tissue grafting, the first year demonstrated excellent integration and successful prosthetic restoration. The two-year follow up still demonstrated successful clinical and aesthetic outcomes. However, radiological findings revealed ambiguous resorption patterns in the scaffold area, prompting concerns about potential complications.

Conclusions: This case highlights the benefits of using CAD/CAM-based β-TCP scaffolds for complex alveolar ridge augmentation, offering enhanced predictability and reduced perioperative technical challenges. Despite the complication of soft tissue dehiscence, the long-term clinical outcome was favorable. Further clinical research is necessary to assess the long-term effectiveness and possible limitations of β-TCP scaffolds in regenerative and reconstructive dentistry, particularly regarding resorption patterns and soft tissue integration. Close clinical monitoring is recommended to ensure optimal healing and prevent any adverse effects on the treatment outcome.