Evaluation of the Proximal Tibia as a Donor Site of Cancellous Bone for Intraoral Grafting Procedures-A Retrospective Study.

Piotr Malara,Nadine Von Krockow,Beata Malara,Iwona Niedzielska

doi:10.3390/jcm11061493

Piotr Malara, Nadine Von Krockow + Show 2 more

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https://doi.org/10.3390/jcm11061493

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Abstract

Background: Autogenous bone grafts remain the “gold standard” in maxillofacial reconstructive procedures. The objective of this study was to evaluate the proximal tibia as a donor site of cancellous bone for bone grafting procedures of the mandible on the basis of intraoperative parameters and clinical observations. Methods: The study was based on a medical record search of 40 patients who underwent surgical procedures because of benign pathological lesions of the jaws resulting in 3-wall bone defects of the mandible and qualified for surgical removal of the lesion with simultaneous bone grafting of the defect with autogenous cancellous bone harvested from the proximal tibia. Results: The use of the proximal tibia for bone grafting procedures enables large amounts of cancellous bone (15.09 cc in average) to be obtained. The procedure is characterized by a low risk of early and late complications, which include excessive bleeding, wound infection, lengthy healing time, scars, a loss of sensation around the scars, aching, a dip in bone, swelling and tenderness. Conclusions: The ability to obtain large amounts of cancellous bone and a low risk of intra- and postoperative complications make the proximal tibia an attractive donor site for the bone grafting procedures in maxillofacial surgery.

Highlights

One of the current problems of up-to-date implant dentistry is alveolar bone deficit in a vertical or transversal dimension
The time needed for making an opening in the cortical bone with a trephine bur and collection of the cancellous bone ranged from 19 to 29 min (23.74 ± 3.01 on average), which allowed for the acquisition of 8 to 21 cc of the cancellous bone (15.09 ± 3.75 on average)
This volume of cancellous bone proved to be sufficient for complete filling of the mandibular defects created as a result of surgical enucleation of the mandibular cysts in all the patients treated with this technique

Summary

Introduction

One of the current problems of up-to-date implant dentistry is alveolar bone deficit in a vertical or transversal dimension. Remodeling of the alveolar bone is a natural consequence of tooth loss by extraction or injury. It begins in the first few minutes after tooth extraction or avulsion and leads inevitably to some degree of atrophy of the alveolar process [1,2]. In cases of bone deficit, contemporary oral and maxillofacial surgery has many methods of treatment aimed at local alveolar bone regeneration. For this purpose, various techniques are used, including guided tissue regeneration [5], bone grafts [6], and distraction osteogenesis [7]. A prerequisite for the clinical success of this method is to provide the graft at the recipient site with an adequate supply of oxygen and nutrients [9]

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