# Association of the Osseodensification Technique with Soft Tissue Substitute in a Limitrophe Edentulous Area: A Clinical Case Report with 5-Year Follow-Up

## TL;DR

This case report shows that combining osseodensification with tissue regeneration techniques can successfully restore a tooth with long-term stability and aesthetics.

## Contribution

The study demonstrates a novel application of osseodensification combined with guided regeneration for bone and soft tissue expansion in a challenging dental area.

## Key findings

- The combination of osseodensification and GBR/GTR achieved successful bone expansion and implant stability.
- A 5-year follow-up confirmed the esthetic and functional success of the treatment.
- The use of L-PRF and collagen membrane improved soft tissue volume and gingival contour.

## Abstract

The osseodensification (OD) technique differs from conventional milling for dental implant installation in that it preserves the prepared bone and compacts it toward the apex and lateral walls of the socket, resulting in bone compaction. By enabling autografting, bone expansion, and high implant insertion torques, OD has become an increasingly popular option. The aim of this clinical case report is to demonstrate the predictability of combining OD with guided bone and tissue regeneration (GBR/GTR) techniques for bone expansion in the maxilla with reduced thickness, while avoiding other reconstructive surgeries. The report presents the treatment of a 32-year-old female patient who had cosmetic concerns regarding the anterior maxillary region. The patient was using an adhesive prosthesis with pontic on tooth 13 fixed between teeth 12 and 14. After the case was planned, it was decided that bone expansion in the region would be performed using the OD technique. The implant installation (AR Torque, 3.5 × 11.5 mm, Conexão®) and guided bone regeneration (GBR) were done with the assistance of L-PRF (Stick Bone, associated with L-PRF membrane). Following the osseointegration period, a provisional resin crown was fabricated, and a collagen matrix membrane (Mucoderm®) was used to increase vestibular soft tissue volume and shape the patient's gingival profile. After a period of 120 days, the final crown was created and observed for a span of 5 years. The results showed stability of the case along with maintaining its esthetic and satisfactory function. The use of the osseodensification technique coupled with a connective tissue graft substitute has been anticipated for a long time. It has proven to be an excellent alternative to autogenous grafts.