Complications in the use of the mandibular body, ramus and symphysis as donor sites in bone graft surgery. A systematic review

Abstract

BackgroundTo develop a systematic review by assessing and comparing the different complications that occurs in bone graft surgery using the mandibular body, ramus and symphysis as donor sites.Material and MethodsIn order to respond to the following question, a systematic review was developed: does the use of intraoral mandibular body and ramus as donor sites in bone graft surgery, produce fewer and less severe complications in comparison to the use of the mandibular symphysis in patients that present bone resorption that needs augmentation using autologous grafts? The review was carried out between January 1990 and 2015, during which only clinical essays with a minimum follow-up period of six months were included.ResultsThe initial search yielded a total of 2912 articles, of which 6 were finally selected. In total, 259 graft surgeries were performed; 118 using the mandibular body and ramus as donor sites, and 141, the symphysis. The most frequent complications that arose when using the mandibular symphysis were temporary sensory alterations in the anterior teeth (33.87%), followed by sensory alterations of the skin and mucosa (18.57%). As for the mandibular body and ramus donor sites, the most frequent complications relate to temporary sensory alterations of the mucosa (8.19%) and to minor postoperative bleeding (6.55%).ConclusionsThe analyzed results show a higher prevalence and severity of complications when using mandibular symphysis bone grafts, producing more discomfort for the patient. Therefore, it would be advisable to perform further clinical essays due to the lack of studies found. Key words:Alveolar ridge augmentation, autogenous bone, mandibular bone grafts, chin, mandibular symphysis, mandibular ramus.

Characteristics of intrabony nerve canals in mandibular interforaminal region by using cone‐beam computed tomography and a recommendation of safe zone for implant and bone harvesting

“…A few cases have reported severe complications and even life‐threatening. A systematic review reported the most common complications were temporary sensory alterations in the anterior teeth (33.87%), followed by sensory alterations of the skin and mucosa (18.57%) . A prospective clinical study reported neurosensory disturbances following bone harvesting were found in 43.3% of the patients .…”

All-on-4 treatment of an edentulous patient after autogenous grafting

“…28 However, especially in the presence of mandibular anterior teeth, dental necrosis in the region and the risk of numbness are among the disadvantages of this practice. 29 In our case, the mandibular anterior region was chosen since the region is completely edentulous, CBCT examinations show that the area is not only sufficient as donor site but also implant placement in the later stage, and besides bilateral access will be required for the other alternative donor site, the ramus region which was already thin for the patient. Despite the proven success of implants placed in grafted areas, the number of case reports or studies carried out in the long-term follow-up of All-on-4 concept in the grafted regions in the literature is very small.…”

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

“…3 Within the mouth, the mandible tends to present more sources than the maxilla, and the anterior border of the ramus, the mandibular body, or the symphysis are almost always preferred as donor sites. 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.…”