Abstract
Introduction:Autologous bone is considered to be the “gold standard” for the reconstruction of the reabsorbed alveolar ridges. For small defects, autologous bone samples can be harvested from intraoral donor sites. However, extraoral donor sites are the first choice for any extensive augmentation of the alveolar ridges. The resorption of the bone grafts depends on several factors, including the recipient sites, the donor sites, volume of the bone grafts and whether or not the patient smokes. The aim of this study was to investigate the rate of autologous bone graft resorption, 4 months after the surgical reconstruction, according to their sites of origin, parietal or ramus, according to the grafted site, mandible or maxilla and according to the surgical indications.Patients and methods:22 patients had 51 reconstructions of alveolar ridges with ramic or parietal onlay bone grafts. The increase of bone volume was assessed with computed tomography, immediately after augmentation (V0) and 4 months after the procedure (V1), before the placement of dental implants.Results:The mean rate of bone resorption was 26% for the parietal bone grafts and 27% for the ramus bone grafts after 4 months (p: ns). This rate was 26% for maxillary grafts and 25% for mandibular grafts (p: ns). This rate varies from 22% to 33% according to the etiology of the bone defect but these variations are not significant and ultimately, this rate of bone resorption was unaffected by the gender of patients.Conclusion:Based on these findings, the resorption of onlay grafts doesnʼt seems to be affected by the recipient and donor sites nor by the etiology of the bone defects. Parietal and ramic bone grafts showed limited resorption rates for the pre-implant reconstruction of alveolar ridges.
Highlights
An autologous bone is currently recognized as the gold standard for alveolar bone reconstruction of the maxilla, mainly for implant purposes [1,2]
Given the legislation in force at the time, no ethical authorization was necessary after consulting the institution’s clinical research department. It included 51 autologous bone grafts in 22 consecutive patients, whose bone volumes were insufficient to allow the placement of dental implants from the outset
The analysis of bone resorption rates at 4 months did not show a significant difference according to the anatomical origin of the autologous graft [parietal versus ramus: 25.94% (±12%) and 26.84% (±14%), respectively; p = 0.80; Fig. 4)], which did not show a significant difference between the resorption rates of maxillary and mandibular grafts with average resorption rates of 25.79% (±13%) and 25.52% (±12%), respectively (p = 0.84; Fig. 5)
Summary
An autologous bone is currently recognized as the gold standard for alveolar bone reconstruction of the maxilla, mainly for implant purposes [1,2]. When a pre-implant bonereconstruction is considered, the choice of the sampling site essentially depends on the size of the defect to be corrected. Intraoral sampling sites include the mandibular symphysis, mandibular ramus, and maxillary tuberosity [5]. The most commonly used extraoral sample in pre-implant reconstruction is the parietal bone [6]. The resorption of autologous grafts is a derogatory factor which must be taken into consideration at the time of reconstruction [7]. This resorption is variable and depends on several criteria, including the sampling and recipient sites [6]
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