Abstract
BackgroundCalvarial bone grafts as a pre-implant augmentation procedure are mostly used to reconstruct the edentulous maxilla, although calvarial grafts could also be used in the partially dentate patients needing extensive bone grafting.MethodsIn 7 consecutive partially dentate patients needing bone grafting because of a large bony defect as a result of trauma (n = 1), oligodontia (n = 1), failed previous bone augmentation (n = 1), or atrophy (n = 4), the alveolar process was reconstructed with calvarial bone as a pre-implant procedure.ResultsA total of 30 implants was placed either immediate at the time of bone grafting (13 implants) or after a healing time of 4 months when immediate placement was not possible (17 implants). One wound dehiscence occurred that needed secondary intervention. During follow-up (40 ± 14 months), one implant was lost due to peri-implantitis with an infected osteosynthesis screw. Marginal peri-implant bone loss was 0.65 ± 0.47 mm during this period.ConclusionCalvarial bone is a sound extra-oral donor site when aiming for reconstruction of a large bony defect of the alveolar process of partially dentate patients.
Highlights
When teeth are lost, the remaining defect in the dental arch can be bothersome to the patient for aesthetic or functional reasons
Calvarial bone grafts can serve as an alternative to anterior iliac crest bone grafts
A limitation is possible scar visibility in bald patients or palpable contour deficits [5]. In this prospective cases series, we report the outcome of calvarial bone grafting in 7 partially dentate patients needing a pre-implant augmentation procedure with extra-oral bone
Summary
The remaining defect in the dental arch can be bothersome to the patient for aesthetic or functional reasons. In case of an insufficient bone volume at the defect location, a reconstructive procedure is needed to allow for a sufficient bone volume to support the implants, e.g., a local bone augmentation [1]. The most common extra-oral grafting site is still the anterior iliac crest [2]. Copious amounts of bone can be harvested from this site, major disadvantages of harvesting bone from the anterior iliac crest are donor site morbidity (pain and gait problems) and the unpredictable resorption of the graft after grafting [3]. Calvarial bone grafts as a pre-implant augmentation procedure are mostly used to reconstruct the edentulous maxilla, calvarial grafts could be used in the partially dentate patients needing extensive bone grafting
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