Background : Bone graft harvest from the mandibular symphysis has been well-documented for the horizontal reconstruction of the atrophic anterior maxilla. However, the long-term volumetric stability of bone augmentation using autogenous symphysis bone graft, as well as the influencing factors in regards to the volumetric resorption still remain unclear in the current literature. Aim/Hypothesis : This study is aimed to evaluate the linear and volumetric effects of using autogenous symphysis bone graft to reconstruct the anterior atrophic maxilla, as well as the influencing factors associated with the volumetric resorption of augmented recipient sites. Materials and Methods : Eight individuals were recruited into the study and led to a total of 9 horizontal bone augmentation surgeries in the anterior maxilla using the autogenous blocks obtained from the mandibular symphysis. The cone-beam computed tomography (CBCT) images were obtained from baseline (T0) as well as 10-14 days (T1) and 6-12 months (T2) after bone graft surgery. The CBCT volumetric data were accessed using a two-dimensional orthogonal multiplanar reformatting viewer for linear gain evaluation. The bone volume in the region of interest (ROI) was measured from three time-points and the cortical bone ratio in the maxilla was assessed at T0. Volumetric differences in the ROI between T1 and T2 were analyzed using paired t-test. The correlation between bone resorption rate and study factors were assessed using multiple linear regression analysis Results : Eight individuals(6 male and 2 female; age 30.4 ± 12.1 years old) showed an average cortical bone ratio of 24.92 ± 6.29% in the maxilla. The linear gain in the recipient area at T1 and T2 was 6.20 ± 2.41 mm and 3.70 ± 1.69 mm, respectively. The volume gain in the ROI at T1 and T2 was 595.49 ± 118.46 mm3 and 426.15 ± 101.17 mm3, respectively. The average bone resorption rate was 25.83 ± 19.07%, which was significantly correlated to the cortical bone ratio (P = 0.0029) in the recipient area, evidenced by multi-linear regression analysis. Conclusions and Clinical Implications : This study confirmed that autogenous bone block from mandibular symphysis acted as an effective horizontal bone reconstruction method for in atrophic anterior maxilla, and the bone resorption rate was strongly related to the cortical bone ratio of the recipient site. It might be beneficial in clinics to keep aware of the patients with a high cortical bone ratio for potential augmentation failure possibly due to the rapid bone resorption rate.
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