Digitally customized bone block allograft with enamel matrix derivative for ridge reconstruction: Case series. Histological report in humans
Abstract
BACKGROUND
Alveolar ridge resorption following tooth extraction is a common clinical challenge that can compromise esthetics, implant placement, and prosthetic rehabilitation. Digital customization of bone block allografts offers precise adaptation to the recipient site, improving graft stability and reducing surgical time. Enamel matrix derivative (EMD) has demonstrated potential to enhance osteogenic differentiation and cell adhesion; however, its application in combination with digitally customized bone block allografts (DCBBAs) remains scarcely reported. This study aimed to evaluate, bone regeneration following alveolar ridge reconstruction using a DCBBA combined with EMD through histologic and histomorphometric analysis.
METHODS
Three systemically healthy, non-smoking patients with severe Seibert Class III ridge defects were treated using a DCBBA with adjunctive EMD. Grafts were digitally planned and milled based on CBCT data to achieve an ideal fit. EMD was applied to both the graft and recipient site before fixation. After 6 months of healing, re-entry surgery was performed for implant placement, during which six bone biopsies were obtained for histologic and histomorphometric evaluation.
RESULTS
Clinically, all grafts exhibited stable integration without signs of inflammation or necrosis. Histological analysis revealed new bone formation in close contact with residual allograft particles, with viable osteocytes and osteoblasts throughout the regenerated area.…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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