Evaluation of bone availability for grafts in different donor sites, through computed tomography

Abstract

Evaluation of bone availability for grafts in different donor sites, through computed tomography Objective: To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap. Methodology: For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal.For the cranial bone, a hexagonal donor site located in parietal area was considered. Results: The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm 3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm 3 . In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm 3 was obtained. Conclusions: Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.

Morphometric analysis of the palatine triangle in adult human skulls: a potential aid for anthropologists and intraoral bone grafts

“…Compared to extraoral sites, intraoral donor sites like the palatine process of the maxilla are more advantageous owing to their location, accessibility, size, and type of graft [ 7 , 11 ]. Most of the studies conducted to date are preliminary clinical and radiological studies on the available bone volume in the palatine bones of the maxilla as an alternate source for intraoral grafts [ 12 ]. In only one study on dry skulls, the authors conclude that the anterior palatal region could be a reliable donor site for maxillofacial and oral surgery procedures [ 13 ].…”

Position of lingual foramina in cone beam computed tomography and its implications for choosing the dimensions of dental implants for mandibular symphysis

“…Surgical procedures, such as the removal of an autogenous graft and the installation of dental implants in the chin region, involve the risk of perforation of the lingual cortical of the mandibular ridge with profuse bleeding, formation of a submental hematoma, airway obstruction, and dissemination of severe infection to the mediastinum [4][5][6].…”

Three-dimensional assessment of the maxillary and mandibular donor sites on cone-beam computed tomography images using Mimics software

“…Ingrowth of blood vessels from the surrounding bone into the defect site provides a path for bone progenitor cells and subsequent new bone formation. In cases with lower number of bony walls and greater alveolar bone atrophy, techniques and materials with higher potential for biological activity and greater regenerative capacity are required [3].…”

“…CBCT is a diagnostic imaging modality especially for assessment of the maxillofacial complex. It enables reconstruction of oral and maxillofacial skeletal structures without distortion and with lower radiation dose than computed tomography [3]. Several studies have con rmed the reliability of CBCT for precise volumetric and dimensional measurements, and assessment of bone quality at the donor site and also for identi cation of the position of anatomical structures [2,4,5].…”