A New Method to Harvest Ramus Bone Using the Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser

Abstract

Autogenous, monocortical block grafts are used extensively in alveolar ridge augmentation prior to implant placement. The main indication is either a defect or atrophy in the anteroposterior or buccolingual dimension, which will prevent implant placement. Donor sites available for implant reconstruction have been described in the literature. Extraoral donor sites such as the ilium, 1 Keller E.E. vanRoekel N.B. Desjardins R.P. et al. Prosthetic-surgical reconstruction of the severely resorbed maxilla with iliac bone grafting and tissue-integrated prostheses. Int J Oral Maxillofac Implants. 1987; 2: 155 PubMed Google Scholar calvaria, 2 Cain J.R. Mitchell D.L. Markowitz N.R. et al. Prosthodontic restoration with dental implants and an intraoral cranial bone onlay graft A case report. Int J Oral Maxillofac Implants. 1993; 8: 98 PubMed Google Scholar , 3 Donovan M.G. Dickerson N.C. Hanson L.J. et al. Maxillary and mandibular reconstruction using calvarial bone grafts and Branemark implants A preliminary report. J Oral Maxillofac Surg. 1994; 52: 588 Abstract Full Text PDF PubMed Scopus (103) Google Scholar clavicle, 4 Listrom R.D. Symington J.M. Osseointegrated dental implants in conjunction with bone grafts. Int J Oral Maxillofac Implants. 1988; 17: 116 Abstract Full Text PDF Scopus (108) Google Scholar and scapula 5 Buchbinder D. Urken M.L. Vickery C. et al. Functional mandibular reconstruction of patients with oral cancer. Oral Surg Oral Med Oral Pathol. 1989; 68: 499 Abstract Full Text PDF PubMed Scopus (53) Google Scholar require hospitalization and are not without potential morbidity. The tibia is not recommended, as only cancellous bone is available in satisfactory amounts for grafting procedures. 6 Lee C.Y.S.L. An in-office technique for harvesting tibial bone Outcomes in 8 patients. Oral Implantol. 2003; 29: 181 Crossref Google Scholar Intraoral ramus grafts from the mandible have also been used and should be the primary harvest site when possible. Advantages are reduced in-office operative and anesthesia time, low morbidity, and ease of surgical access, which can be accomplished under local anesthesia or intravenous sedation. For the young patient who has not had the mandibular third molars removed, harvesting of ramus grafts with simultaneous removal of the third molar should also be considered, as only one surgical procedure is required. The armamentarium to harvest bone from the ramus of the mandible is usually a fissure bur in a high-speed handpiece or oscillating saw. The purpose of this article is to introduce a new alternative method to harvest ramus bone from the mandible using the latest generation laser, the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser.