Quantitation of Mandibular Symphysis Volume as a Source of Bone Grafting

Abstract

AutoCAD did not overestimate the volume of bone that can be safely harvested from the mandibular symphysis. The use of the design software program may improve surgical treatment planning prior to sinus augmentation.

Computed Tomographic Analysis of the Mandibular Body and Ramus in Japanese Patients

“…Unfortunately, in the study by Yamamoto et al, 5 it is not possible to discern the actual course of the inferior alveolar nerve canal and its various sites of contact with the external cortical bone of the ramus and it is in consideration for sagittal split ramus osteotomy, not for bone harvesting from the mandibular ramus. Verdugo et al 8 reported that the mandibular second and third molar areas provided the thickest cortical graft averaging 2.8 6 0.6 mm and that the thinnest bone was immediately posterior to the third molar area (1.9 6 0.3 mm). However, they did not mention the linear distance between the superior aspect of the inferior alveolar nerve canal and the alveolar crest but also the linear distance between the buccal aspect of the inferior alveolar nerve canal and the buccal cortical bone.…”

Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

“…The microstructure is a crucial factor in determining the degree of revascularization. In cancellous bone, the large marrow spaces between the trabeculae allow a better and faster revascularization, while in cortical bone, the high density of bone lamellae impedes blood vessel development, which will be therefore limited to Volkmann's and Haversian canals 13. Although cancellous bone revascularizes earlier and better on one side, it would be more subjected to resorption on the other side in the presence of compressive forces 14…”

“…Primarily, the limits of the mental region have been defined by Verdugo et al,12 who evaluated the volume that could be safely harvested from the symphysis region during surgery, to preserve the dental element's vitality superiorly, not to damage the inferior alveolar nerve laterally, and not to compromise the structural resistance of the mandible for preservation of the lingual cortical plate inferiorly.…”

“…There were few other studies4,12,23-28 that measured the bone volume harvestable from the symphysis region. By the previously reported methodology, the cortical and cancellous bone volumes have been computed.…”

“…At this stage, the "create nerve" tool showing the course of the left and right mandibular canal either on the cross sections or in the 3D reconstructions was used. The "mental region"11,12 was defined as bounded by lines 5 mm in front of the medial margin of each mental foramen for the lateral limit, 5 mm under the apex of each tooth present on the cross-sectional image for the upper limit, and the upper part of the inferior mandibular cortex on the crosssectional image for the lower limit (Fig. 2).…”