| Summary: | The presence of non-sufficient bone height and width requires an increase in the amount of bone available to insert an implant. Different materials are described in the literature, and the “custom-made bone graft approach” is a modern option which currently requires a preoperative stage of studying the bone defect and designing the implant. SmartBone<sup>®</sup> (SB<sup>®</sup>) mimics the characteristics of healthy human bone. Thanks to the strong performance, high workability, resistance and shape retention of SB<sup>®</sup>, it is possible to obtain SmartBone<sup>®</sup> on Demand<sup>TM</sup>, a bone graft uniquely shaped exactly to patient specifications, produced by following the data precisely and contoured to the bone defect site. The aim of this study was to determine the success over 7 years following a customized SmartBone<sup>®</sup> on Demand<sup>TM</sup>, a xeno-hybrid bone graft and installation of implants in a maxillary horizontal and vertical atrophy. This case study presents the diagnosis for a 60-year-old male patient requesting the rehabilitation of his edentulous maxilla with dental implants. Preoperative evaluation included the study of photographs, a radiological examination and 3D reconstruction to assess the missing bone, implant size, positioning of implants and anatomical landmarks. Rehabilitation included the insertion of a custom-made xeno-hybrid bone block into the maxilla in order to restore the anatomy prior to the implants’ placement. The newly developed bone substitute SB<sup>®</sup> is a safe and effective material, and its custom-made variant SmartBone<sup>®</sup> on Demand<sup>TM</sup> has been shown to be a valid alternative to traditional autologous bone grafting techniques in terms of accuracy, absence of infection/rejection and overall clinical outcome.
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