Allogeneic shells plus autologous dentin

Case briefing: This case report describes the management of a 20-year-old patient with multiple tooth loss due to a motorcycle accident at the age of 16 (Fig 1). The treat- ment plan included a two-stage implant therapy with an allogeneic shell technique combined with autolo- gous, particulated dentin from the wisdom teeth. Treatment plan: Two individualized allogeneic cortical shells were fixed buccally in the region of teeth 12 to 22. In the same session, the maxillary wisdom teeth were surgi- cally removed with subsequent grinding to harvest particulated dentin for the augmentation in the anter- ior region of teeth 12 to 22 (Fig 2a and b, Fig 3). After a healing period of 6 months, patient-specific digital planning was carried out and fully guided im- plants were placed without any further guided bone regeneration procedures (Figs 4 to 6). An interim implant-supported fixed dental pros- thesis (iFDP) was fabricated from polymethyl methac- rylate, and inserted (Fig 7). The soft tissue around the implants and pontic sites was conditioned progres- sively by adding composite resin in order to develop emergence profiles. This was followed by a final digit- al impression and fabrication of the definitive porce- lain-fused-to-metal iFDP (Figs 8 to 10). Conclusions: The main advantages of this treatment were the low risk of morbidity and the upcycling of the patient’s own wisdom teeth. The resulting autologous dentin was ideal as a bone substitute material in terms of biocompatibility and resorption properties.