EVALUATION OF RAMUS AUTOGENOUS BLOCK GRAFT FOR VERTICAL AUGMENTATION OF MANDIBULAR POSTERIOR ALVEOLAR RIDGE

Mandour, Sara M.; Hassan, Nagy E.; Sweedan, Ahmed O.

doi:10.21608/adjalexu.2019.63557

EVALUATION OF RAMUS AUTOGENOUS BLOCK GRAFT FOR VERTICAL AUGMENTATION OF MANDIBULAR POSTERIOR ALVEOLAR RIDGE

Document Type : Original Article

Authors

¹ BDS, MS, Faculty of Dentistry, Alexandria University, Egypt.

² Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.

³ Lecturer of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.

10.21608/adjalexu.2019.63557

Abstract

INTRODUCTION: Bone defects in the human mandible are common. They are mostly determined by premature loss of teeth due to periodontal disease or traumas. They usually cause reduction of alveolar bone volume, which becomes inconsequence, inadequate for standard treatments with Osseo integrated implants. The predictability of the implant survival and the maintenance of long-term stability of implants in function are directly associated with the quality and quantity of the available bone for implant placement. In the case of alveolar ridges with insufficient bone volume vertical, horizontal or sagittal inter-maxillary relationships, additional surgical procedures can be necessary to reconstruct and augment the deficiency. Bone block graft is the preferred method for many types of augmentation procedures, since it secures both a source of osteogenic cells and a rigid structure for mechanical support. In addition, bone block graft conserves its volume better than particulate grafting. OBJECTIVES: This study provides a clinical, radiographic, analysis of the use of mandibular ramus block autografts for vertical alveolar ridge augmentation. The suitability of the bone will be harvested to provide sufficient bone volume to facilitate implant insertion at a second stage. MATERIALS AND METHODS: The present study was conducted on 12 patients with age ranged from20-50 years seeking implantation of their lost posterior mandibular teeth, and have limited bone height. Patients were selected on the basis of history, clinical examination and radiographic examination using panoramic radiography and CBCT. RESULTS: in this study 10 patient out of 12 showed successful vertical bone augmentation with autogenous bone graft harvested from the ramus of the mandible with 83.33% success rate. CONCLUSIONS: using ramus autogenous bone graft in augmentation of vertical bone defects in the posterior area of the mandible has significant success.

Keywords

Main Subjects

Oral and maxillofacial surgery

References

Roccuzzo M, Ramieri G, Bunino M, Berrone S. Autogenous bone graft alone or associated with titanium mesh for vertical alveolar ridge augmentation: a controlled clinical trial. Clin Oral Implants Res. 2007;18:286-94.
Soehardi A, Meijer GJ, Strooband VF, de Koning M, Stoelinga PJ. The potential of the horizontal ramus of the mandible as a donor site for block and particular grafts in pre-implant surgery. Int J Oral Maxillofac Surg. 2009;38:1173-8.
Al-Ardah AJ, Alqahtani F, Lozada JL. Surgical technique for harvesting autogenous mandibular symphysis graft - US Patent 9,265,797, 2016.
Stimmelmayr M, Gernet W, Edelhoff D, Güth JF, Happe A, Beuer F. Two-stage horizontal bone grafting with the modified shell technique for subsequent implant placement: a case series. Int J Periodontics Restorative Dent. 2014;34:269-76.
Pommer B, Zechner W, Watzek G, Palmer R. To Graft or not to graft? Evidence-based guide to decision making in oral bone graft surgery. In: Zorzi A, Batista J (eds). Bone grafting. 1st ed. Ch 11. Published online: InTech Open; 2012. p 1-25.
Barone A, Ricci M, Mangano F, Covani U. Morbidity associated with iliac crest harvesting in the treatment of maxillary and mandibular atrophies: A 10-year analysis. J Oral Maxillofac Surg. 2011;69:2298-304.
Oppenheimer AJ, Tong L, Buchman SR. Craniofacial bone grafting: Wolff’s law revisited. Craniomaxillofac Trauma Reconstr. 2008;1:49-61.
Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology – is it still a "gold standard"? A consecutive review of 279 patients with 456 clinical procedure. Int J Implant Dent. 2017;3:23.
Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg. 2014;43:606–25.
Munoz Garcia J, Vidal Marcos AV, Restoy Lozano A, Gasco Garcia C. Utility of bis-pectral index monitoring during intravenous sedation in the dental office. Int J Oral Maxillofac Implants. 2012;27:375–82.
Louis PJ, Gutta R, Said-Al-Naief N, Barto-lucci AA. Reconstruction of the maxilla and mandible with particulate bone graft and titanium mesh for implant placement. J Oral Maxillofac Surg. 2008;66:235–45.
Pelo S, Boniello R, Moro A, Gasparini G, Amoroso PF. Augmentation of the atrophic edentulous mandible by a bilateral two-step osteotomy with autogenous bone graft to place osseointegrated dental implants. Int J Oral Maxillofac Surg. 2010;39:227–34.
Cordaro L, Torsello F, Accorsi Ribeiro C, Liberatore M, Mirisola di Torresanto V. Inlay–onlay grafting for threedimensional reconstruction of the posterior atrophic maxilla with mandibular bone. Int J Oral Maxillofac Surg. 2010;39:350–7.
Khoury F, Happe A. Soft tissue management in oral implantology: a review of surgical techniques for shaping an esthetic and functional peri-implant soft tissue structure. Quintessence Int. 2000;3:483–99.
Cordaro L, Amade DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients priorto implant placement. Clin Oral Implants Res. 2002;13:103–11.
Proussaefs P, Lozada J. The use of intraorally harvested autogenous block grafts for vertical alveolar ridge augmentation: a human study. Int J Periodontics Restorative Dent. 2005;25:351–63.
De Stavola L, Tunkel J. Results of vertical bone augmentation with autogenous bone block grafts and the tunnel technique: a clinical prospective study of 10 consecutive- ly treated patients. Int J Periodontics Restorative Dent. 2013;33:651–9.
Mazzocco C, Buda S, De Paoli S. The tunnel technique: a different approach to block grafting procedures. Int J Periodontics Restorative Dent. 2008;28:45–53.
Ersanli S, Arısan V, Bedeloğlu E. Evaluation of the autogenous bone block transfer for dental implant placement: Symphysal or ramus harvesting? BMC Oral Health 2016;16:4.
Schwartz-Arad D, Levin L, Sigal L. Surgical success of intraoral autogenous block onlay bone grafting for alveolar ridge augmentation. Implant Dent. 2005;14:131–8.
Laviv A, Jensen OT, Tarazi E, Casap N. Alveolar sandwich osteotomy in resorbed alveolar ridge for dental implants: a 4-year prospective study. J Oral Maxillofac Surg. 2014;72:292–303.