Hindawi Publishing Corporation
Case Reports in Dentistry
Volume 2013, Article ID 154795, 7 pages
http://dx.doi.org/10.1155/2013/154795
Case Report
Treatment of the Atrophic Upper Jaw:
Rehabilitation of Two Complex Cases
Andrea Enrico Borgonovo,
1
Andrea Marchetti,
1
Virna Vavassori,
1
Rachele Censi,
2
Ramon Boninsegna,
3
and Dino Re
1
1
Istituto Stomatologico Italiano, Department of Oral Rehabilitation, School of Oral Surgery, University of Milan,
via Pace, 21, 20122 Milan, Italy
2
Department of Implantology and Periodontology III, Istituto Stomatologico Italiano, Milan, Italy
3
Department of Clinical and Experimental Sciences, University of Brescia, Italy
Correspondence should be addressed to Virna Vavassori; virna.vavassori@hotmail.it
Received 22 May 2013; Accepted 29 June 2013
Academic Editors: S. S. de Rossi and R. Sorrentino
Copyright © 2013 Andrea Enrico Borgonovo et al. Tis is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
In reconstructive surgery, the fresh frozen homologous bone (FFB) represents a valid alternative to the autologous bone, because
FFB allows bone regeneration thanks to its osteoinductive and osteoconductive properties. Te purpose of this work is to describe
the surgical-implant-prosthetic treatment of two complex cases using FFB. In particular, fresh frozen homologous bone grafs were
used to correct the severe atrophy of the maxilla, and, then, once the graf integration was obtained, implant therapy was performed
and implants placed in native bone were immediately loaded.
1. Introduction
Te implant-prosthetic rehabilitation is a current practice in
clinic dentistry and is characterized by safe and predictable
results in the long term [1]. However, in order to obtain
the success of implant therapy, in the preliminary stages it
is essential to assess and classify the amount of available
bone. In fact, this evaluation is fundamental for the correct
implant placement, according to the principles of modern
prosthetically driven implant placement [2].
Several classifcations have been proposed to assess the
amount of available bone. In the Lekholm and Zarb [3] classi-
fcation (1985), the jaw bone shape is classifed on a fve degree
scale. Cawood and Howell [4] (1988) proposed another
classifcation that diferentiates the atrophies according to an
analysis of three-dimensional alveolar ridges. Te presence of
unfavorable crestal anatomy, which may result from diferent
situations such as atrophy, periodontal disease, iatrogenic or
congenital defects, trauma, or oncological resection, is not
an absolute contraindication to dental implant placement. In
fact, with the advances and evolution occurring in implant
dentistry, new surgical techniques have been developed and
refned in order to allow the correction of bone defects and
the implant-prosthetic management of compromised sites.
One of the most common procedures for the correction
of bone defects involves autologous (or autogenous) bone
grafing (bone is harvested from the patient’s own body).
Autologous bone is typically harvested from intraoral sources
[5] as the chin, the mandibular ramous, the tuber maxilla or
from extraoral sources as the iliac crest, the fbula, and even
parts of the skull [6]. Other graf materials, which are used in
clinical practice, are the xenograf bone substitutes, derived
from a species other than human, such as bovine, the allograf
bone, like autogenous bone which is derived from humans,
and at last, the artifcial bone, such as bioglass, hydroxya-
patite, or calcium phosphate [2]. For the reconstruction of
extended bone defects, autologous or homologous bone grafs
are preferred, in form of blocks, in order to restore the correct
vertical and/or horizontal dimensions.
Only recently, the homologous bone has been introduced
in the reconstructive surgery and maxillofacial surgery,
although it has been used for many years in orthopedics for