Authors:	Kämmerer, Peer Wolfgang Tunkel, Jochen Götz, Werner Würdinger, Robert Kloss, Frank Pabst, Andreas
Title:	The allogeneic shell technique for alveolar ridge augmentation : a multicenter case series and experiences of more than 300 cases
Online publication date:	20-Apr-2023
Year of first publication:	2022
Language:	english
Abstract:	Purpose Allogeneic cortical bone plates (CP) might be used for alveolar ridge augmentation as an alternative to autogenous grafts (AG) and bone substitutes (BS). We report about a multicenter case series and our experiences of more than 300 cases using CP and the shell technique for reconstruction of the alveolar process to illustrate surgical key steps, variations, and complication management. Methods Different types of alveolar ridge defects were augmented using the shell technique via CP. The space between the CP and the alveolar bone was filled with either autogenous or allogeneic granules (AUG, ALG) or a mixture of both. Implants were placed after 4–6 months. Microscopic and histological assessments were performed. In addition, space filling using AUG, ALG and bovine BS was discussed. Results Scanning electron microscopy demonstrated the compact cortical structure of CP and the porous structure of ALG allowing micro-vessel ingrowth and bone remodeling. Histological assessment demonstrated sufficient bone remodeling and graft resorption after 4–6 months. In total, 372 CP cases and 656 implants were included to data analysis. The mean follow-up period was about 3.5 years. Four implants failed, while all implant failures were caused by peri-implantitis. Next, 30 CP complications were seen, while in 26 CP complications implant placement was possible. CP rehydration, stable positioning by adjusting screws, smoothing of sharp edges, and a tension-free wound closure were identified as relevant success factors. Space filling using ALG and a mixture of AUG/ALG resulted in sufficient bone remodeling, graft resorption and stability of the augmented bone. Conclusions CP and the shell technique is appropriate for alveolar ridge augmentation with adequate bone remodeling and low complication rates. Allografts can prevent donor site morbidity and therefore may decrease discomfort for the patient.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8898
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	International journal of implant dentistry 8
Pages or article number:	48
Publisher:	Springer
Publisher place:	Berlin u.a.
Issue date:	2022
ISSN:	2198-4034
Publisher URL:	https://doi.org/10.1186/s40729-022-00446-y
Publisher DOI:	10.1186/s40729-022-00446-y
Appears in collections:	DFG-491381577-G