Reconstruction of the alveolar ridge in a severely atrophied maxilla to enable implant placement is a challenge. Recent studies have suggested that the use of Ti-meshes may contribute to achieve extensive alveolar ridge augmentation. Although different designs of Ti-meshes have been proposed in the last few years to enhance bone graft stabilization and to minimize the risk of collapse and/or soft tissue dehiscence, the difficulty in cutting and shaping of Ti-mesh to fit the defect site during surgery still remained. Objectives: The purpose of this report was to demonstrate a new method using the reverse-engineering(RE) technique to fabricate a customized Ti-framework for alveolar ridge augmentation in a severely atrophied maxilla. Methods: CT scan examination was performed on a fully edentulous and severely atrophied maxilla before augmentation. 3D image of maxilla was obtained with raw CT data (a DOS format)input to Mimics software version 4.0 (Materialise N.V., Belgium). A 3D resin model of maxilla was built by stereolithography. The desired volume of ridge augmentation was simulated on the model by adding wax. A casting titanium meshed framework was fabricated in a dental laboratory on the prepared maxillary model. Corticocancellous bone graft was harvested from the iliac crest and placed against the Ti-framework fixed to the bone. After 6 months of healing the titanium framework was removed. 9 dental implants were placed using SurgiGuide surgical templates (Materialise Co., Belgim). Abutment connection was carried out 9 months after implant placement. Results: It was found that no implant was lost. Conclusions: The preliminary result suggested that, by using the customized titanium framework and autogenous bone grafts, patients with severely atrophied maxilla could be successfully rehabilitated by means of implant-supported prosthesis. Fabrication of the customized Ti-framework to fit the bone defect is easily achieved and it reduces the surgery time.

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