Abstract
Objective To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap.Methodology For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the “distance” tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered.Results The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained.Conclusions Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.
Highlights
The rehabilitation of edentulous patients has occupied a prominent place in Dentistry
Autogenous bone grafts are often used to correct defects related to the bone volume of the recipient site, mainly because they are still considered the gold standard when compared with biomaterials
This study was approved by the Research Ethics Committee of the University Center
Summary
The rehabilitation of edentulous patients has occupied a prominent place in Dentistry. The access may reveal difficulties related to visibility and limitations on the graft size and shape, impairing the bone volume.7 Most studies on this subject report an advantage of the skullcap toward the other sites because it is a corticalized bone that undergoes less resorption, leading to more predictable results for the installation of implants, both in the maxilla and mandible, with lower postoperative morbidity. Conebeam computed tomography (CBCT) is a diagnostic imaging method, especially indicated to examine the dentomaxillofacial complex, which enables the reformation of the maxillofacial bones without distortion and image-guided radiation dosing, with reduced costs.4 This examination technique improves the visualization of images and structures in a way that was not possible with the conventional radiography.. As in any type of surgery, careful planning is essential; three-dimensional analysis using computed tomography is very useful. Conebeam computed tomography (CBCT) is a diagnostic imaging method, especially indicated to examine the dentomaxillofacial complex, which enables the reformation of the maxillofacial bones without distortion and image-guided radiation dosing, with reduced costs. This examination technique improves the visualization of images and structures in a way that was not possible with the conventional radiography. this visualization capacity was used to quantify the bone availability, since studies that inform and discuss the bone volume that can be removed were not found in the scientific literature
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