Beta-Tricalcium Phosphate (β-TCP) for Customized Bone Regeneration (CBR) in the Esthetic Area of the Maxillary...

Beta-tricalcium phosphate (β-TCP), a ceramic material renowned for its excellent biocompatibility, is widely used in oral tissue regeneration due to its superior osteoconductive properties. This case report presents the surgical and prosthodontic management, along with 2-year clinical and radiologic follow-ups, of a patient-specific β-TCP scaffold designed using CAD/CAM for the augmentation of a complex maxillary anterior alveolar ridge defect.

A 37-year-old man presented with a malpositioned implant in the anterior maxilla, initially placed during adolescence. Ongoing alveolar ridge growth resulted in increased infraposition, exposed implant surface, and esthetic concerns, which required repeated prosthetic corrections. Implant removal was followed by treatment involving a patient-specific β-TCP scaffold to address both functional and esthetic deficiencies. The scaffold was designed by means of CAD/CAM, providing a tailored solution for bone augmentation. Because the final restoration was planned without an implant-based rehabilitation, a resorbable magnesium screw was chosen as the fixation element to minimize the need for reintervention. Despite a buccal dehiscence that necessitated additional soft tissue grafting, at the 1-year follow-up the scaffolding demonstrated excellent integration and successful prosthetic restoration. The 2-year follow-up still demonstrated successful clinical and esthetic outcomes. However, radiologic findings revealed ambiguous resorption patterns in the scaffold area, prompting concerns about potential complications.

This case highlights the benefits of using CAD/CAM-based β-TCP scaffolds for complex alveolar ridge augmentation, which offer enhanced predictability and reduced perioperative technical challenges. Despite the complication of soft tissue dehiscence, the long-term clinical outcome was favorable. Further clinical research is necessary to assess the long-term effectiveness and possible limitations of β-TCP scaffolds in regenerative and reconstructive dentistry, particularly regarding resorption patterns and soft tissue integration. Close clinical monitoring is recommended to ensure optimal healing and prevent any adverse effects on the treatment outcome.