Autogenous bone harvesting from iliac crest and symphysis for implant reconstruction

Abstract

Horizontal and vertical bone resorption may be seen after tooth loss in the maxilla and mandible. The deficient edentulous ridge may interfere with the insertion of implants of adequate length placed in the correct position and with the ideal inclination. The severe alveolar bone resorption or pneumatisation of the maxillary sinus makes it difficult to perform the conventional dental implantation procedure. Functional implant-supported oral rehabilitation is increasingly being used as a restoration strategy for fully and partially edentulous patients, whenever sufficient bone volume is available. Implant-supported restoration is possible even in severely resorbed jaws using a reconstruction technique with bone augmentation that includes vascularised or nonvascularised bone grafting and tissue regeneration techniques. Standard donor sites for free autogenous bone-graft techniques are: the chin or ramus mandible, the iliac crest, the tibia and the calvaria. Advantages of intraoral mandibular sources include easy access, low morbidity, short healing periods, minimal graft resorption, and maintenance of high bone density; side effects include possible postoperative sensory disturbances and discomfort. Calvaria and iliac crest donor areas are most commonly used in cases of extensive alveolar ridge augmentation. The iliac crest generally supplies large quantities of corticocancellous bone. In this report, we present autogenous bone graft harvesting of 48 patients (40 iliac anterior crest, 8 symphysis) for facial reconstructive surgery.