Prefabricated CAD‐CAM scaffolds for management of oro‐antral communication: A case report and histological analysis

Abstract

AbstractIntroductionOro‐control communication is one of the complications associated with dental extraction and oral surgeries. This case report presents a minimally invasive surgical approach for bone regeneration at the site of oro‐antral communication utilizing a prefabricated computer‐aided design and computer‐aided manufacturing (CAD‐CAM) allogenic bone block.MethodsA 20‐year‐old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro‐antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD‐CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non‐resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation.ResultsClosure of the oro‐antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5‐month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune‐histochemical staining by anti‐vascular epithelial growth factor expression index value was 32.06%.ConclusionsA prefabricated CAD‐CAM scaffold was successfully used to seal a large oro‐antral communication and regenerate sufficient bone to place a dental implant.