ABSTRACT
The reconstruction of alveolar ridge defects can be challenging, especially when the lesion is large, non-contained, and located in the esthetic region. The present report describes the guided bone regeneration (GBR) procedure and prosthetic rehabilitation of a severe perforation defect in the anterior maxilla. Clinical and radiographic evaluation of the lesion indicated an endodontic-periodontal origin, and biopsy results confirmed the absence of malignancy. GBR was performed with the use of cortical mineralized freeze-dried bone allograft (FDBA) combined with recombinant human platelet derived growth factor BB (rhPDGF-BB) and a resorbable collagen membrane without the use of tenting or fixation screws. At six months post-GBR, cone beam computed tomography (CBCT) revealed adequate bone fill for the placement of 4.1 x 10 mm or 4.1 x 12 mm dental implants. The implant surgery was fully guided with a two-stage approach. After a ten-month of healing phase, the implants were loaded with a screw-retained porcelain bridge. The staged GBR approach using a combination of FDBA, rhPDGF-BB, and a resorbable membrane without the use of tenting or fixation screws resulted in significant bone fill, successful implant placement, and a functional and esthetic implant-supported prosthesis.
