Human Bone Repair After Mandibular Symphysis Block Harvesting: A Clinical and Tomographic Study

Abstract

The osteogenic potential of human osseous repair in the mandibular symphysis is size and time dependent. The process of osteogenesis of repair in humans seems to be multifactorial. Such factors as preservation of the periosteum and symphysis cortical midline may positively influence defect fill allowing for reharvesting.

Exploring CBCT-Based DICOM Files. A Systematic Review on the Properties of Images Used to Evaluate Maxillofacial Bone Grafts

“…Screening yielded 12 citations that potentially met the inclusion criteria, but nine papers were excluded for the following reasons: two papers regarded the possibility of using CBCT in the evaluation of bone surgery, including bone grafts, but without clinical results [15,16]; one paper was in vitro [17]; one paper was based on the fate of the donor area and not the fate of the graft [18]; two papers were based on other techniques to achieve bone augmentation-membrane alone and split-crest technique [19,20]; one paper did not aim at evaluating the outcome of CBCT [21]; and two papers regarded the use of CBCT in the planning of the implant to be inserted in the grafted area, but did not concern the graft itself [22,23].…”

Healing of donor defect after mandibular parasymphyseal block harvesting: A 6-year computerized tomographic follow-up

“…If the chin defect was not filled with a bone substitute, thereby requiring physiological healing, a rough volumetric analysis described the long-term healing of defects (average of 34.2 mos) with a size less of 0.5 cc, yielding a result of healing of 81%; the volumetric analysis of defects with a size larger than 0.5 cc showed a repair of 63.8%, but the healing time (7.2 mos) was not sufficient to indicate the timing and the expectation of physiological healing in the long-term (Verdugo et al, 2010).…”

“…1B); intrasurgical block volumes were extrapolated by linear measurements as described by Verdugo et al (2010).…”

“…Both short-term and long-term neurosensory disturbances following chin bone harvesting procedures, including alteration in lip and pulp sensitivity, have been described in several studies (Nkenke et al, 2001;von Arx et al, 2005;Sbordone et al, 2009;Weibull et al, 2009), although no long-term evaluation of defect healing has been clearly stated (Verdugo et al, 2010): in one recent paper, the size-and time-dependence of the healing of the donor-site defect was described: long healing times were required for large defects (>0.5 cc), but minimal defects (<0.5 cc) were followed-up for a sufficient healing period (average of 34.2 mos), giving a mean of 81% bone fill (Verdugo et al, 2010).…”

A Comparative Volumetric Study of Symphysis Donor Defects, Unfilled or Filled with Bone Substitute

“…19,20 The reduced bone volume of unfilled defects as compared with the filled defects does not allow the use of the same donor sites for block reharvesting at 6 or even 18 months postoperationally. Moreover, unfilled defects exhibited a nonstatistically significant increase in bone volume at 18 months postsurgery.…”