Two-stage horizontal bone grafting with the modified shell technique for subsequent implant placement: a case series

This case series evaluated the graft stability and resorption of a modified shell technique for horizontal ridge augmentation. Autogenous bone shells of 1-mm thickness were fixed with microtitanium screws with the gaps between the shells and ridge filled with autogenous bone chips. In 22 patients, 30 cases were performed to augment 50 regions. Forty-two implants were inserted after a healing period of 5.5 (± 1.0) months. Preoperatively, the mean width of the crest was 2.7 mm (± 0.9), after bone grafting, 6.7 mm (± 0.8), and during implant placement, 5.9 mm (±0.7), and the mean resorption was 0.8 mm (± 0.5) (P < .001). This technique showed promising results. However, due to slight resorption, the ridge should be over contoured.