Site preparation prior to implant placement: Veneer grafting

Abstract

Lack of internal loading of the alveolus after removal of the dentition leads to its atrophy. By placing implants within the alveolar bone, reintroduction of internal loading of the bone is achieved. This is the basis of the success and popularity of dental implants. Dental implants not only stabilize patient’s prosthesis, but more importantly they biologically and physically maintain the alveolar bone. Because of their long-term stability, implant supported prosthesis have become accepted as a viable, and at times the recommended treatment for edentulous areas. However, inadequate residual alveolar width excludes implants in this patient group. Various methods have been reported for ridge augmentation to facilitate placement of implants. The purpose of this presentation is to discuss treatment options available for site preparation prior to implant placement. These procedures include guided tissue regeneration iliac bone grafting, cranial bone grafting, mandibular symphasis grafting, and mandibular ramus veneer grafting. The technique of veneer grafting using autogenous mandibular ramus bone is used by the present author for horizontal bone augmentations. The ability to harvest flat cortical bone grafts extending 25 to 30 mm in length makes the mandibular ramus a desirable intraoral donor site. The postoperative perception by the patient is similar to that of an extraction site, and patients are therefore more tolerant of the postoperative edema and necessary home care. References Bedrossian E: Int J Oral Maxillofac Implants. 15: 2000 Rangert B: Int J Oral Maxillofac Implants. 4: 1989 Misch CM: Int J Oral Maxillofac Implants. 7: 1992