AutoresRoberto Ledergerber, Javier Flores-Fraile, Tiago Marques, Javier Soldevila, Martin Lindström, Norberto Quispe-López
Las barreras de zirconio personalizadas mediante CAD/CAM buscan aportar estabilidad mecánica y precisión digital a la regeneración ósea guiada en defectos tridimensionales. Esta serie de tres casos con atrofia maxilar severa describe el protocolo completo: planificación con CBCT y escaneo intraoral, diseño y fabricación individualizada de la barrera, injerto de hueso autógeno y xenoinjerto, e implantes con cirugía guiada tras la cicatrización. Las tres cirugías se completaron sin complicaciones y permitieron colocar los implantes sin aumentos adicionales, con ganancias medias de 6,17 mm en horizontal a nivel crestal y 2,62 mm en vertical. La histología mostró hueso neoformado vital y bien vascularizado. Aporta además un método digital reproducible para medir los cambios óseos, aunque se basa en solo tres pacientes.
Background: CAD/CAM zirconia barriers represent an advanced option for guided bone regeneration (GBR) in three-dimensional defects, integrating mechanical stability, biocompatibility, and digital precision. The objectives of this case series were to evaluate, clinically, histologically, and three-dimensionally, the use of customized zirconia barriers designed using CAD/CAM technology in GBR procedures. Methods and results: Three patients with severe maxillary bone atrophy were included and treated with GBR using customized zirconia barriers. Digital planning was performed based on cone beam computed tomography and intraoral scanning, followed by CAD/CAM design and fabrication of the barriers. The defects were regenerated using a mixture of autogenous bone and xenograft. After the healing period, implants were placed using guided surgery, and bone biopsies were obtained for histological analysis. Bone gains were evaluated through linear and volumetric digital analysis based on three-dimensional model superimposition. All surgeries were completed without complications, allowing implant placement in all cases without the need for additional augmentation procedures. Mean horizontal bone gains of 6.17 mm at the crestal level and mean vertical gains of 2.62 mm were recorded, with maximum values of up to 5.11 mm. Volumetric analysis revealed bone gains of 797.158 mm³ (case 1), 459.718 mm³ (case 2), and 1416.870 mm³ (case 3). Histological analysis demonstrated vital, well-vascularized newly formed bone undergoing active remodeling, with no evidence of inflammation. Conclusions: Customized zirconia barriers demonstrated favorable clinical and histological outcomes in GBR. The digital workflow, combined with three-dimensional analysis, allowed a precise and reproducible evaluation of bone changes.
Ledergerber R, Flores-Fraile J, Marques T, Soldevila J, Lindström M, Quispe-López N. Guided bone regeneration using CAD-CAM zirconia barriers: A case series with digital evaluation of bone changes. Clinical Advances in Periodontics. 2026. doi:10.1002/cap.70121
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