Alveolar Bone Augmentation Using Octacalcium Phosphate and Collagen Composite with Custom-Made Titanium Mesh: A Case Report.

BACKGROUND Extensive bone augmentation using artificial bone substitutes is difficult because of their inferior bone regeneration ability compared with that of autologous bone. However, octacalcium phosphate (OCP) and OCP collagen composite (OCP/Col) are better bone substitutes than other materials. Herein, we report a case of extensive alveolar-bone augmentation using OCP/Col and a titanium mesh for restoration of the occlusion and aesthetics using dental implants. CASE REPORT An 18-year-old man with maxillary anterior alveolar-bone deficiency due to a traffic accident was referred to our hospital for dental implant treatment. The bilateral maxillary central incisors were missing, and the labial alveolar-bone volume was insufficient. Radiographic examination and preoperative simulations revealed that the alveolar bone was insufficient for dental implant placement. Bone augmentation was performed using OCP/Col and a custom-made titanium mesh according to the ideal shape determined through simulation. The periosteum was incised to expand the mucosa, and the wound was then sutured. The patient was required to eat soft foods for several days, and movement around the upper lip was restricted using taping. Six months after bone augmentation, reconstruction of the ideal alveolar morphology was confirmed, and dental implants were placed. After the final prosthesis was inserted, the occlusion and esthetics were restored, and the patient's quality of life significantly improved. CONCLUSIONS In this patient, an extensive alveolar-bone defect was reconstructed with an ideal alveolar shape using OCP/Col and a titanium mesh. This case report presents the first clinical application of OCP/Col combined with a custom titanium mesh for repairing large alveolar bone defects in the maxillary anterior teeth.