Guided Bone Regeneration at the Donor Site of Iliac Bone Grafts for Future Use as Autogenous Grafts

Abstract

Autogenous bone grafting is considered the standard in management of bony defects but has some disadvantages, including limited source of graft material, especially in children. This study represents an attempt to regenerate bone at the donor site of iliac bone grafts using the guided bone regeneration principle for future use in multistage bone reconstruction by grafting. Critical size defects were created in 24 iliac bones of 12 skeletally mature New Zealand White rabbits. Defects in group 1 (n = 12) were covered with inverted U-shaped resorbable mesh (space maintainer) and polytetrafluoroethylene membranes underneath the periosteum. In group 2 (n = 6), inverted U-shaped resorbable mesh was used alone (positive control). In group 3 (n = 6), neither resorbable mesh nor polytetrafluoroethylene membranes were used (negative control). An unpaired t test was used for comparison between each two groups. Plain radiographs and contact microradiographic studies showed that bone regeneration was significantly higher in group 1 and group 2 than in group 3 (p < 0.001). There was no significant difference between group 1 and group 2 regarding density. The periosteum acted as an ideal membrane for guided bone regeneration so that the polytetrafluoroethylene membranes could be used only to compensate for the deficient periosteum. Space maintenance was essential for bone regeneration.