The biological mechanism and clinical application of bone shell technique in alveolar bone augmentation
10.12016/j.issn.2096-1456.202660036
- Author:
CHEN Zetao
1
;
GAO Xiaomeng
1
;
OUYANG Zhaoguang
1
;
AO Yong
1
;
GUO Xinyu
1
Author Information
1. Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Clinical Research Center of Oral Diseases
- Publication Type:Journal Article
- Keywords:
dental implant site;
alveolar bone defect;
bone shell technique;
guided bone regeneration;
incre⁃ment of alveolar bone;
autologous bone;
allogeneic bone;
bone substitute materials;
barrier membrane
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2026;34(4):315-327
- CountryChina
- Language:Chinese
-
Abstract:
A portion of patients undergoing implant restoration require bone augmentation procedures to ensure that there is sufficient bone volume around the implant. For the patients with horizontal bone ridge defects at edentulous sites, with or without mild to moderate vertical bone defects, the shell technique serves as a reliable and minimally invasive bone augmentation method with effective space maintenance. The shell technique involves fixating 1 mm cortical bone blocks to the recipient site, using retention screws and filling the gap between the bone block and recipient bed with particulate bone substitute materials, and covering the barrier membrane to achieve bone augmentation. The overlying tension-free soft tissue closure seals the surgical site while local peripheral blood releases osteoclasts and cytokines that gradually degrade the bone block. The rigid fixation of the bone block ensures a stable internal environment for osteogenesis and a new bone regeneration cycle. Although this technique demonstrates favorable bone augmentation outcomes, it is highly technique-sensitive. There are certain differences in the application scenarios and osteogenic processes for autologous and allogeneic bone shells. The selection of bone blocks and particulate bone substitute materials significantly influences the osteogenic biological process and the predictability of bone augmentation results. Complications associated with the shell technique possess distinct characteristics, such as the immunogenicity of allogeneic bone fragments, soft tissue cracking, and bone fragment loosening. Their prevention and subsequent management substantially impact the success rate of osteogenesis. This article delves into the biological mechanisms of osteogenesis in the bone block technique, summarizing the indications, clinical outcomes, classification of bone blocks, and surgical workflow management, as well as complication prevention and management, aiming to provide a reference for the future application and development of the bone shell technique.
- Full text:2026041611330001862骨片技术在牙槽骨增量中的生物机理及临床应用.pdf
