3D-driven alveolar ridge augmentation based on reverse planning: a retrospective case series study.

Authors

Fanni Bolya-Orosz, Balint Molnar, Željka Perić Kačarević, Peter Windisch, Daniel Palkovics

Published in

BMC oral health. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

Reconstruction of advanced vertical and combined alveolar ridge defects still remains a challenge in implant dentistry. Digital technologies and virtual planning may potentially improve the predictability of guided bone regeneration (GBR). This study aimed to evaluate a fully digital, reverse-planning workflow for vertical ridge augmentation using membrane-cutting guides.
This retrospective case series included 15 surgical sites presenting with vertical or combined alveolar ridge defects. A digital workflow integrating cone-beam computed tomography (CBCT), intraoral scanning, and virtual prosthetic planning was used to simulate ideal implant positions and corresponding hard tissue augmentation. Membrane-cutting guides were designed and fabricated using additive manufacturing to shape dense polytetrafluoroethylene membranes. Vertical GBR was performed using a split-thickness flap design and a tent-pole approach. Linear and volumetric hard tissue changes were assessed by comparing baseline and 9-month postoperative CBCT scans.
Significant vertical bone gain was observed at all measurement points (p = 0.007), with mean increases from 15.70 mm ± 4.34 mm to 19.96 mm ± 3.83 mm at the central site. The mean volumetric hard tissue gain was 755.33 mm³ ± 411.22 mm³, closely matching the planned volume (757.50 mm³ ± 417.78 mm³), with no significant difference (p = 0.649). Using Spearman's correlation, a strong positive correlation was found between planned and achieved volumes (Spearman's ρ = 0.825, p = 0.0004). The mean augmentation efficacy was 20.13 ± 15.21 mm³/mm.
The proposed 3D-driven reverse-planning workflow enabled predictable vertical ridge augmentation with high agreement between planned and achieved outcomes. This approach represents a feasible and accessible alternative to fully customized systems; however, further prospective controlled studies are required to validate these findings.

PMID:
42401878
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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