Alternative intraoral donor sites to the chin and mandibular body-ramus

Abstract

BackgroundProvide a review of alternative intraoral donor sites to the chin and body-ramus of the mandible that bring fewer complications and that may be used to regenerate small and medium defects.Material and MethodsA review was conducted using the search engine PUBMED and looking manually into scientific journals.ResultsFrom the 35 articles included, 6 corresponded to the coronoids, 3 corresponded to the zygomatic body, 5 corresponded to the anterior maxillary sinus wall, 3 corresponded to the zygomatic alveolar process, 2 corresponded to the incisive fossa, 2 corresponded to the anterior nasal spine, 2 corresponded to the palatal region, 5 corresponded to the tuberosity, and 7 corresponded to the palatal and mandibular tori.ConclusionsAlthough there are few complications described when using alternative intraoral donor sites, the main problem with these types of grafts is their scarce bone volume, with only the zygomatic body, anterior sinus wall, and palate sites being able to be used in medium defects. More clinical trials are necessary in order to evaluate the behavior of the alternative donor sites over time. Key words:Grafting, autologous bone, autografts, mandible, maxilla, palate hard, zygoma.

The “One Piece” Autologous Tuberosity Graft: A Contemporary Concept in Ridge Preservation

“…It has a unique advantage of retaining cell viability and containing osteoblasts and osteoprogenitor stem cells which provides true osteogenesis [34]. In this technique, the maxillary tuberosity showed no complications and better accessibility, an advantage when we know that other intraoral donor sites such as the chin and the ramus present significant postoperative bleeding, swelling, discomfort, and risk of nerve injury [35]. A limitation to its usage is the reduced available amount of bone that makes it an indication in small or medium-sized defects [36,37].…”

Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography

“…The rate of loss of dental sensation observed in published research varies, with a range of 2 patients to 37 patients. 11,[17][18][19] However, no plausible reason for the loss of dental sensation has been identified in the literature. Furthermore, Cordaro et al 17 considered 4 mm to be a sufficient safety margin to avoid this problem, whereas other studies left a safety margin of 5 mm.…”

“…8 Mandibular bone grafts result in better-quality bone and a shorter healing period than other methods of bone repair. 4 Other advantages include minimal resorption (5%-28%), 9,10 no need for hospitalization (and thus lower cost), 6 minimal discomfort, 11 no alteration in ambulation, and the absence of cutaneous scars. 7 Compared to other mandibular sites, the symphyseal area has advantages such as easy accessibility, the presence of both cortical and cancellous bone volume (with greater cancellous bone mass), and suitability for bone defects involving up to 1-6 teeth.…”

Computer‐guided calvarial mono‐cortical bone blocks harvest: A novel approach for three‐dimensional alveolar reconstruction of atrophic maxilla

“…The jaws are characterized by their intramembranous bone origin and so they are preferred as the intramembranous bones have less resorption rates over time when compared to bone grafts of endochondral origin, but they cannot be used in severely atrophied cases, because a massive amount of bone is needed to rebuild the lost volume back for implant insertion and then loading. In cases with massive resorption of the maxilla or the mandible, as the jaws cannot be used as donor sites despite their intramembranous bone type, other sites of intra membranous bones are preferred as skull cap (calvaria) . However, harvesting calvarial blocks could be complicated with breakage through the inner table, cerebrospinal fluid (CSF) leakage, infection, dural tear, and difficulty of separation of the outer cortex from the inner cortex …”

“…In cases with massive resorption of the maxilla or the mandible, as the jaws cannot be used as donor sites despite their intramembranous bone type, 9 other sites of intra membranous bones are preferred as skull cap (calvaria). 6,10 However, harvesting calvarial blocks could be complicated with breakage through the inner table, cerebrospinal fluid (CSF) leakage, infection, dural tear, and difficulty of separation of the outer cortex from the inner cortex. 7,[11][12][13][14][15][16] Hence, the aim of the present study was to introduce a protocol for computer-guided calvarial bone block harvest with the help of a surgical guide that controls the location, cutting depth, and the required amount of bone harvest, to minimize the possible complications encountered with calvarial graft.…”