Block augmentation - allogenic blocks

  • Block augmentation with maxgraft® blocks
    Initial situation
  • Block augmentation with maxgraft® blocks
    Narrow alveolar ridge
  • Block augmentation with maxgraft® blocks
    maxgraft® block screwed to ridge
  • Block augmentation with maxgraft® blocks
    Gap filling with cerabone®
  • Block augmentation with maxgraft® blocks
    Covering with Jason® membrane
  • Block augmentation with maxgraft® blocks
    Wound closure
  • Block augmentation with maxgraft® blocks
    Implantation 6 months after augmentation
Block augmentation is a technique developed for the reconstruction of severely resorbed alveolar ridges and for the regeneration of complex defects. According to the classical concept, autologous bone blocks are harvested from intraoral (e.g. mandibular symphysis, mandibular ramus, retromolar area, or maxillary tuberosity) or extraoral regions (typically the Cresta Iliaca), and the transplants are fixed with osteosynthesis screws to the augmentation site. Owing to its excellent osteogenic and osteoinductive properties, autologous bone is an ideal scaffold for bone regeneration; however, the need for a second surgical site often results in an increased morbidity and post-operative pain as well as a higher risk of infection and complications. These disadvantages, together with the limited availability of autologous bone, prompted the development of various biomaterials. Blocks manufactured from allogeneic sources, such as maxgraft® blocks, are particularly suitable for block augmentation due to the flexibility of the material, which can be easily fixed with osteosynthesis screws.

Wound closure

Please carefully consider the soft tissue situation prior to the surgical intervention! Keep in mind that a tension-free closure of the flap is essential for the success of the entire procedure.

Block application

Avoid large gaps between the graft and defect. A close contact between the transplant and bone bed ensures a successful incorporation of the block and faster regeneration.

Protection against resorption

Covering the block with a particulate slowly resorbable bone-grafting material (e.g., cerabone® or maxresorb®) can help prevent a too-fast resorption and smoothen the surface contours especially in the aesthetic area.

Block smoothing

Avoid sharp edges that might cause a perforation of the overlying soft tissue.

Healing time

The average healing period is about 4 and 6 months for smaller and larger defects, respectively. Insert implants shortly after healing to minimize the risk of resorption.

Block augmentation with maxgraft® clinical case - Michele Jacotti
Blockaugmentation mit maxgraft® - Dr. Michele Jacotti

Due to the unique production process (e.g. no sintering), maxgraft® blocks retain their collagen matrix and the natural biomechanical properties of the bone matrix; this provides the excellent handling properties of this material. For experienced oral and maxillofacial surgeons, allograft bone blocks for block augmentation are the only real alternative to harvesting the patient's autologous bone. Although the adjustment of the block shape prior to insertion can be relatively time consuming, this procedure provides a stable implant bed and a highly predictable outcome.

An appropriate soft tissue management that allows a tension-free wound closure is of the utmost importance. In addition, the sharp edge smoothing as well as the covering of the bone block with a slowly resorbing barrier membrane, such as the Jason® membrane, can help prevent soft-tissue perforation and ensure an undisturbed healing. The covering of the block with a particulate slowly resorbable bone-grafting material (e.g. cerabone® or maxresorb®) can help prevent a too-fast resorption and smoothen the surface contours especially in the aesthetic area.

In contrast to allogenic bone blocks, the purely mineral bovine or synthetic bone blocks are very brittle and therefore hard to shape or fix. Block augmentation with cerabone® or maxresorb® blocks is a challenging technique, only suitable for surgeons with prior experience with such materials.

Please Contact us for Literature.