The Use of the Mandibular Ramus for Alveolar Reconstruction in Oral Implantology

Abstract

Bone grafts are widely used in alveolar ridge augmentations to allow correct implant installations. Intraoral donor sites, such as the maxillary tuberosity, symphysis and mandibular ramus have presented good characteristics and outcomes; however, the mandibular ramus has comparative advantages that promote its increased use. The aim of this work is to describe the current results of the mandibular ramus as a donor site for obtaining bone grafts to be used in alveolar bone augmentations in oral implantology and to determine the survival rate of the implants installed in the grafted sites. A systematic search of the scientific literature between December 2000 and March 2017 was carried out on the MEDLINE, EMBASE, LILACS and SciELO databases, analyzing each article according to the method of diagnosis and planning, bone resorption at the receptor site, presence of postoperative complications and implant survival rate. Eleven works were included in this study with an average of 43 patients; the follow-up times varied between 6 and 120 months, considering in addition an average success rate of 98.7 % in the implants installed in sites reconstructed with mandibular ramus bone; low morbidity in the site mainly linked to temporary neurosensory alterations was identified. It may be concluded that the need for a second surgical site to obtain graft material and the longer time the treatment requires until implant rehabilitation continue to be disadvantages; nevertheless, the mandibular ramus donor site presents low morbidity, high versatility in its use and predictable results for the dental implant installation.