Three-Dimensional Maxillary Alveolar Ridge Augmentation Using Three-Dimensional Maxillary Alveolar Ridge Augmentation Using Modified Cortical Shell Technique and Composite Bone Graft

Objective: The present study was performed to assess the 3D alveolar ridge augmentation using the cortical shell from retromolar region and composite bone particulate regarding the width of the residual alveolar ridge. Methods: Thirteen patients with age range 21-40 years old having atrophic anterior maxillary ridge ≤3mm horizontally were included in the study. All patients were subjected to ridge augmentation using composite bone graft and retromolar cortical shell that was fixed in place by two micro-screws. The alveolar ridges were assessed and compared by cone beam computed tomography (CBCT) in the pre-operative, immediate and 4 months post-operative phases by taking linear measurements at the same points after making fusion. The measurements were taken at the crest of the ridge, midway and more apically. The CBCT images were evaluated for the actual gain in width of the alveolar ridge. Statistical analysis was performed to compare CBCT and clinical findings. Results: At the crest of the ridge, midway and more apically the results showed a statistically significant difference between pre-operative and immediate post-operative results (P0.05). The mean increases in crestal bone width, midway and apically at 4 months postoperatively were 3.66mm, 4.01mm and 3.5mm respectively. Conclusion: 3D reconstruction of anterior maxillae with autogenous retromolar cortical shell is a reliable technique with stable outcomes. Two micro- screws Stabilization provides stability and minimal graft resorption. Moreover, the technique allows for implant placement 4 months post-operatively without further re-grafting.