Title: Vertical ridge augmentation: Alternative approach for the severe atrophic alveolar ridge
One of the most challenging scenarios for the implantodontist is the treatment of severe atrophic alveolar ridge. It is well known that the crestal bone reduces volume after the tooth extraction and can retract the volume more than 50% in the first 6 months. The bone resorption can be accelerated by the use of prosthesis, compressing the reminiscent crest. Although there was a great improvement of the implant quality, and possibility to use nowadays short implants, for example 4mm long, still, the relation of implant/crown length is unbalanced. Another possible alternative therapy is the use of dentogingival prosthesis to camouflage the ridge deficiency. At the present time, the need of the increasing bone volume and height is an advantage to the implant stability and long-term maintenance. Not long time ago, the only way to obtain result was the use of bone blocks, most of them, autogenous. It used to be traumatic to the patient because it was needed a second surgical site for the removal of the graft. It was even worse when great reconstructions must have been redone and had to use an extra-oral approach. By the philosophy of: “simplicity is the ultimate sophistication”, it is associated with the recent change of dentistry for the minimal invasive treatment, and excellent biomaterial found in dental industry. The grafting technique to create bone in critical defects became simpler and less traumatic. In fact, the necessity of autogenous bone is minimal, only to guarantee vital cell and bone induction. The association of autogenous particles with osteoconductive xenograft, those which have slow rate resorption in a 50/50 proportion inside a scaffold, created by a non-resorbable membranes (ptfe barriers) with titanium reinforcement, have improved considerably the graft perspective and creating a less invasive, less traumatic treatment, but with more predictable results.