Implant rehabilitation partial maxillary edentulism with onlay autogenous chin bone grafting and prosthetic gingival restoration: A case report

Background: Atrophic anterior maxilla rehabilitation can be a challenging procedure due to multiple factors that influence clinical decision making. After a prolonged loss of teeth, the residual bone often impedes the use of standard implant placement protocols and additional procedures are needed. Aim: The aim of this study is to describe the multidisciplinary approach for the diagnosis and treatment of a 50-year-old woman with prolonged use of a removable maxillary partial denture. Case Description: This article presents a full-mouth-phased rehabilitation of an atrophic anterior maxilla with three surgical stages. First, onlay autogenous chin bone grafting was used to return the lost tissue. After the consolidation, dental implants were placed in a second stage. A few months later, a connective tissue graft was used to improve the keratinized mucosa width. In the mentioned stages, leukocyte- and platelet-rich fibrin (L-PRF) was used to improve healing and promote tissue regeneration. Finally, prosthetic gingival restoration was used in the anterior region as an alternative to overcome the limitations of hard- and soft-tissue grafting. Conclusion: The use of autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represents a predictable procedure for the rehabilitation of the long-term partial maxillary edentulism. Prosthetic gingival restoration is an alternative technique to overcome the limitations of hard- and soft-tissue grafting. Clinical significance: The treatment of a patient with high and width alveolar bone loss needs a multidisciplinary approach. Autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represent an effective procedure. Also, prosthetic gingival restoration can be used as an alternative technique to overcome the limitations of hard- and soft-tissue grafting.