Customized CAD/CAM coral hydroxyapatite block for horizontal ridge augmentation in severe bone defects: A case report

Limited data are available on the application of customized bone blocks for horizontal ridge augmentation, particularly those fabricated using coral hydroxyapatite (CHA). The present case report describes a technique for bone augmentation using a customized CHA bone block. The efficacy and clinical feasibility of the technique were evaluated in a 21-year-old man with missing mandibular central incisors and a severe bone defect, with a horizontal bone width of only 2-3 mm. A customized CHA bone block for guided bone regeneration was designed using preoperative cone-beam computed tomography (CBCT) data and computer-aided design and fabricated using a computer-aided manufacturing technique. Following augmentation surgery using the CHA bone block, the soft tissue healed well without dehiscence or infection. After 10 months, CBCT showed that the bone width had increased to 4-8 mm and the implant was inserted. When assessed 7 months later, the value of the implant stability quotient was 70, and the definitive restoration was completed. The customized CHA bone block simplified the surgical procedure, reduced surgical time and minimized postoperative reactions. Therefore, it may serve as a potential alternative to the autogenous bone graft. However, enhancement of the osteoinductive and osteogenic properties of the CHA block would be beneficial, and further studies are required to achieve this.