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Three-dimensional evaluation of the different donor sites of the mandible for autologous bone grafts

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Abstract

Objectives

For effective placement of endosseous implants, a sufficient volume of bone is required at the recipient site. The aim of this study is to evaluate the density and maximum amount of harvestable bone graft required from the mandible symphysis, coronoid process, and ascending ramus, depending on dentition.

Materials and methods

CT data from 42 patients (13 females and 29 males) in DICOM format were read using special planning software. Three different virtual bone grafts were created, and the dimension outcomes, surface, volume, and density were measured in a dentate group (n = 22) and a total edentulous group (n = 20).

Results

Comparisons between corresponding bone grafts showed no difference for the symphysis and coronoid process in relation to dentition, and no difference in bone density was observed. However, significant changes between the average values of the ramus were found between the two groups (p < 0.0001).

Conclusions

Appropriate software and CT data can deliver more accurate examinations of the mandible in relation to potential donor sites. Atrophy primarily affects the ascending ramus; the symphysis and coronoid process are only slightly influenced.

Clinical relevance

Using appropriate software in conjunction with implant planning, it is possible to analyze potential donor areas within the jaw and create virtual bone grafts

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References

  1. Boyne PJ, Cole MD, Stringer D, Shafqat JP (1985) A technique for osseous restoration of deficient edentulous maxillary ridges. J Oral Maxillofac Surg 43:87–91

    Article  PubMed  Google Scholar 

  2. Engelke D, Engelke W (1989) Primary sulcoplasty with hydroxylapatite augmentation for extreme ridge resorption. Dtsch Z Mund Kiefer Gesichtschir 13:367–372

    PubMed  Google Scholar 

  3. Jensen OT, Cockrell R, Kuhike L, Reed C (2002) Anterior maxillary alveolar distraction osteogenesis: a prospective 5-year clinical study. Int J Oral Maxillofac Implants 17:52–68

    PubMed  Google Scholar 

  4. Uckan S, Dolanmaz D, Kalayci A, Cilasun U (2002) Distraction osteogenesis of basal mandibular bone for reconstruction of the alveolar ridge. Br J Oral Maxillofac Surg 40:393–396

    Article  PubMed  Google Scholar 

  5. Simion M, Fontana F (2004) Autogenous and xenogeneic bone grafts for the bone regeneration. A literature review. Minerva Stomatol 53:191–206

    PubMed  Google Scholar 

  6. Misch CM, Misch CE, Resnik RR, Ismail YH (1992) Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report. Int J Oral Maxillofac Implants 7:360–366

    PubMed  Google Scholar 

  7. Khoury F, Buchmann R (2001) Surgical therapy of peri-implant disease: a 3-year follow-up study of cases treated with 3 different techniques of bone regeneration. J Periodontol 72:1498–1508

    Article  PubMed  Google Scholar 

  8. Misch CM (1997) Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 12:767–776

    PubMed  Google Scholar 

  9. Jensen J, Sindet-Pedersen S (1991) Autogenous mandibular bone grafts and osseointegrated implants for reconstruction of the severely atrophied maxilla: a preliminary report. J Oral Maxillofac Surg 49:1277–1287

    Article  PubMed  Google Scholar 

  10. Khoury F (1999) Augmentation of the sinus floor with mandibular bone block and simultaneous implantation: a 6-year clinical investigation. Int J Oral Maxillofac Implants 14:557–564

    PubMed  Google Scholar 

  11. Klinge B, Alberius P, Isaksson S, Jonsson J (1992) Osseous response to implanted natural bone mineral and synthetic hydroxylapatite ceramic in the repair of experimental skull bone defects. J Oral Maxillofac Surg 50:241–249

    Article  PubMed  Google Scholar 

  12. Misch CM (2000) Use of the mandibular ramus as a donor site for onlay bone grafting. J Oral Implantol 26:42–49

    Article  PubMed  Google Scholar 

  13. Yavuz MS, Buyukkurt MC, Tozoglu S, Dagsuyu IM, Kantarci M (2009) Evaluation of volumetry and density of mandibular symphysis bone grafts by three-dimensional computed tomography. Dent Traumatol 25:475–479

    Article  PubMed  Google Scholar 

  14. Yates DM, Brockhoff HC 2nd, Finn R, Phillips C (2013) Comparison of intraoral harvest sites for corticocancellous bone grafts. J Oral Maxillofac Surg 71:497–504

    Article  PubMed  Google Scholar 

  15. Montazem A, Valauri DV, St-Hilaire H, Buchbinder D (2000) The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 58:1368–1371

    Article  PubMed  Google Scholar 

  16. Gungormus M, Yavuz MS (2002) The ascending ramus of the mandible as a donor site in maxillofacial bone grafting. J Oral Maxillofac Surg 60:1316–1318

    Article  PubMed  Google Scholar 

  17. Gungormus M, Yilmaz AB, Ertas U, Akgul HM, Yavuz MS, Harorli A (2002) Evaluation of the mandible as an alternative autogenous bone source for oral and maxillofacial reconstruction. J Int Med Res 30:260–264

    Article  PubMed  Google Scholar 

  18. Modabber A, Gerressen M, Stiller MB, Noroozi N, Fuglein A, Holzle F, Riediger D, Ghassemi A (2012) Computer-assisted mandibular reconstruction with vascularized iliac crest bone graft. Aesthet Plast Surg 36:653–659

    Article  Google Scholar 

  19. Modabber A, Legros C, Rana M, Gerressen M, Riediger D, Ghassemi A (2012) Evaluation of computer-assisted jaw reconstruction with free vascularized fibular flap compared to conventional surgery: a clinical pilot study. Int J Med Robot 8:215–220

    Article  PubMed  Google Scholar 

  20. Brugnami F, Caiazzo A, Leone C (2009) Local intraoral autologous bone harvesting for dental implant treatment: alternative sources and criteria of choice. Keio J Med 58:24–28

    Article  PubMed  Google Scholar 

  21. Choung PH, Kim SG (2001) The coronoid process for paranasal augmentation in the correction of midfacial concavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:28–33

    Article  PubMed  Google Scholar 

  22. Gellrich NC, Held U, Schoen R, Pailing T, Schramm A, Bormann KH (2007) Alveolar zygomatic buttress: A new donor site for limited preimplant augmentation procedures. J Oral Maxillofac Surg 65:275–280

    Article  PubMed  Google Scholar 

  23. Amrani S, Anastassov GE, Montazem AH (2010) Mandibular ramus/coronoid process grafts in maxillofacial reconstructive surgery. J Oral Maxillofac Surg 68:641–646

    Article  PubMed  Google Scholar 

  24. Herford AS (2004) Dorsal nasal reconstruction using bone harvested from the mandible. J Oral Maxillofac Surg 62:1082–1087

    Article  PubMed  Google Scholar 

  25. Mintz SM, Ettinger A, Schmakel T, Gleason MJ (1998) Contralateral coronoid process bone grafts for orbital floor reconstruction: an anatomic and clinical study. J Oral Maxillofac Surg 56:1140–1144, discussion 1144–5

    Article  PubMed  Google Scholar 

  26. Economopoulos TL, Asvestas PA, Matsopoulos GK, Molnar B, Windisch P (2012) Volumetric difference evaluation of registered three-dimensional pre-operative and post-operative CT dental data. Dentomaxillofac Radiol 41:328–339

    Article  PubMed Central  PubMed  Google Scholar 

  27. Turkyilmaz I, Tumer C, Ozbek EN, Tozum TF (2007) Relations between the bone density values from computerized tomography, and implant stability parameters: a clinical study of 230 regular platform implants. J Clin Periodontol 34:716–722

    Article  PubMed  Google Scholar 

  28. Palomo JM, Rao PS, Hans MG (2008) Influence of CBCT exposure conditions on radiation dose. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:773–782

    Article  PubMed  Google Scholar 

  29. Miracle AC, Mukherji SK (2009) Conebeam CT of the head and neck, part 1: physical principles. AJNR Am J Neuroradiol 30:1088–1095

    Article  PubMed  Google Scholar 

  30. Park HS, Lee YJ, Jeong SH, Kwon TG (2008) Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofac Orthop 133:30–37

    Article  Google Scholar 

  31. de Oliveira RC, Leles CR, Normanha LM, Lindh C, Ribeiro-Rotta RF (2008) Assessments of trabecular bone density at implant sites on CT images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:231–238

    Article  PubMed  Google Scholar 

  32. Lekholm U (1985) Zarb G (1985) Patient selection and preparation. In: Branemark P-I, Zarb GA, Albrektsson T (eds) Tissue integrated prostheses: osseointegration in clinical dentistry. Quintessence, Chicago, pp 199–209

    Google Scholar 

  33. Misch CE (1993) Density of bone: efect in treatment planing, surgical approach and healing. In: Misch CE (ed) Contemporary implant dentistry. Mosvy, St Louis, pp 469–485

    Google Scholar 

  34. Norton MR, Gamble C (2001) Bone classification: an objective scale of bone density using the computerized tomography scan. Clin Oral Implants Res 12:79–84

    Article  PubMed  Google Scholar 

  35. Hohlweg-Majert B, Pautke C, Deppe H, Metzger MC, Wagner K, Schulze D (2011) Qualitative and quantitative evaluation of bony structures based on DICOM dataset. J Oral Maxillofac Surg 69:2763–2770

    Article  PubMed  Google Scholar 

  36. Shapurian T, Damoulis PD, Reiser GM, Griffin TJ, Rand WM (2006) Quantitative evaluation of bone density using the Hounsfield index. Int J Oral Maxillofac Implants 21:290–297

    PubMed  Google Scholar 

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The authors do not have any financial interests or commercial associations to disclose.

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Authors and Affiliations

  1. Department of Oral, Maxillofacial and Plastic Facial Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany

    Stephan Christian Möhlhenrich, Nassim Ayoub, Frank Hölzle & Ali Modabber

  2. Institute of Medical Statistics, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany

    Nicole Heussen

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  1. Stephan Christian Möhlhenrich
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  2. Nicole Heussen
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  3. Nassim Ayoub
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  4. Frank Hölzle
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Correspondence to Stephan Christian Möhlhenrich.

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Möhlhenrich, S.C., Heussen, N., Ayoub, N. et al. Three-dimensional evaluation of the different donor sites of the mandible for autologous bone grafts. Clin Oral Invest 19, 453–458 (2015). https://doi.org/10.1007/s00784-014-1235-0

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  • DOI: https://doi.org/10.1007/s00784-014-1235-0

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