Bone Block Protection using Dense Polytetrafluoroethylene Membranes in Vertical Bone Augmentation Procedures for Atrophic Maxilla: A Case Report

Large vertical bone defects in the posterior maxilla pose a significant challenge for oral and maxillofacial surgeons aiming to rehabilitate the region with dental implants. Autogenous bone grafts remain the gold standard for bone grafting due to their trifecta of osteogenesis, osteoinduction, and osteoconduction properties. Autogenous bone blocks harvested from the anterior iliac crest are a predictable and extensively researched treatment approach for the management of localized or generalized alveolar ridge defects. The primary complications associated with reconstructing atrophic alveolar bone are wound dehiscence and subsequent exposure of the bone graft material to the oral environment, a challenge that may be unavoidable in certain cases.

In this case report, we present the reconstruction of the posterior maxilla in a 30-year-old patient, utilizing an autologous bone graft harvested from the anterior iliac crest. The bone block was then shielded with a dense polytetrafluoroethylene membrane. The bone block was fixed using tenting screws, and the membrane was attached to the tent screws with special screws (tenting cap screws). Membrane exposure occurred two weeks post-surgery, and the membrane was easily removed four weeks after the procedure. There were no signs of infection or loss of bone graft material during this timeframe.

Applying d-PTFE to cover the bone block in extensive posterior maxillary vertical augmentation procedures effectively shields the bone block from bacterial contamination, lowers the likelihood of complications, and enhances the predictability of the procedure.