Mandibular Symphysis Bone Research Articles

Early secondary closure of alveolar clefts with mandibular symphyseal bone grafts and β-tri calcium phosphate (β-TCP)

Alveolar reconstruction of bony defects in cleft lip and palate patients is a widely accepted treatment regimen for which multiple donor sites can be used. For 25 years, autogeneous bicortical mandibular symphyseal bone grafts have been used at the authors' centre. In cases in which the alveolar defect was too large to match the volume of the mandibular symphyseal bone transplant, beta-TCP granules were packed against the bone transplant to fill the defect completely. In a retrospective study, 18 patients, who were treated with mandibular symphyseal bone wrapped in beta-TCP granules, were compared with 29 patients, who were treated with mandibular symphyseal bone only. To assess alveolar height, occlusal radiographs were taken directly postoperatively and 1 year later. Mean alveolar bone loss was calculated and compared between groups using Student's t-test and linear regression analysis. No statistically significant difference in alveolar height was found between the two groups. It was concluded that mandibular symphyseal bone grafts enriched with beta-TCP granules can be used successfully in cases in which the alveolar cleft is too large to be grafted with mandibular symphyseal bone alone.

Orthodontie Treatment Results following Grafting Autologous Mandibular Bone to the Alveolar Cleft in Patients with a Complete Unilateral Cleft

To analyze orthodontic treatment results following mandibular symphysis bone grafting and postoperative orthodontic treatment. Randomized selection of 75 patients out of 308 with unilateral cleft of lip, alveolus, and palate, operated upon according to protocol between 1990 and 2008 in the Wilhelmina Children's Hospital, Utrecht, The Netherlands. Goslon Yardstick rating changes of dental arch relationship. Significant agreement (p < .001) was observed between the two assessments carried out with an interval of 3 months (Cohen's kappa = .963, p < .001). Following mandibular bone grafting and orthodontic treatment in 65.3% of the patients, the aim of treatment (Goslon Yardstick groups 1 and 2) had been achieved. The applied before/after Goslon allocations showed high improvement significance (p < .001). Postoperative orthodontic treatment in patients following grafting with mandibular symphysis bone showed excellent results.

Evaluation of volumetry and density of mandibular symphysis bone grafts by three‐dimensional computed tomography

Bone grafting before implant placing can improve the treatment in traumatized or regular implant patients. The aim of this study was to evaluate the density and maximum amount of harvestable bone graft in the mandibular symphysis. Data from 15 CT-scans were obtained from 15 adult patients (10 male/five female) for the purposes of this study. The CT data, in DICOM format, were read into Mimics software from Materialize (Leuven, Belgium), with a slice thickness of 0.5 mm. The volume, density, and dimensions based on Hounsfield units (HU) were measured on the 3D symphyseal bone graft using Mimics software. The average bone volume calculated from the mandibular symphysis was 3491.08 +/- 772.12 mm(3). The average sized corticocancellous block that was measured was 38.75 x 11.05 x 7.80 mm. The mean bone density was 958.95 +/- 98.11 HU. The use of three-dimensional computed tomography (3D CT) in combination with a software program is a reliable means of determining the density of graft, evaluating maximal volume and dimensions of the graft that can be harvested from the mandibular symphysis region.

Autogenous mandibular symphysis graft for orbital floor reconstruction: a preliminary study

The present study aimed to evaluate and analyze postoperative results of Autogenous Mandibular Symphysis graft material for orbital floor reconstruction. A retrospective study was conducted on 11 patients, having an isolated blow out fracture (n=4) or orbital floor defects associated with other fractures (n=7). These fractures were reconstructed with Mandibular symphysis bone grafts. The Grafts were used where the defects were more than 1.5 centimeter [1]in diameter. Follow up as long as 1.5 year was kept. Patients were evaluated at recall visits by checking various extraoccular movements. Evidence of any complications like diplopia or enopthalmos, or rejection of graft or any symptoms of infection, or of paresthesia was recorded. During a 1.5 year period of follow up, most of the patients had no postoperative complaints. There was good restoration of the orbital floor, with no clinical evidence of enopthalmos or diplopia. Extraoccular movements were intact in all patients. Only one patient presented with the symptoms of infection at a follow up period of 9 months. The infection subsided after removal of titanium plates, used for the stabilization of graft. Autogenous Mandibular Symphysis graft is a good alternative with minimal morbidity for orbital floor reconstruction. The contour as well as the size of the graft available from symphysis region best suits for orbital floor reconstruction.

A New Incision Design for Mandibular Symphysis Bone‐Grafting Procedures

Traditional methods of procuring mandibular symphysis bone grafts may leave soft tissue scarring, and cause paresthesia and lip droop. Nineteen patients selected for treatment were given general health, periodontal, and radiographic evaluations. Patients had inadequate bone volume for dental implant placement or required preprosthetic ridge augmentation procedures. Prior to surgery, bone sounding was performed to determine tissue thickness. All patients had a minimum of 4 mm of keratinized gingiva. Under local anesthesia, incisions were initiated within the keratinized gingiva. Full-thickness mucoperiosteal flaps were elevated, and small burs were used to obtain bone blocks from the mandibular symphysis. A bone-scraping device was used to obtain strips of cortical bone. A combination of sling and interrupted sutures was used for wound closure. All patients healed uneventfully without wound dehiscence, paresthesia, or lip droop. Sufficient bone was obtained for ridge or sinus augmentation with eventual implant placement. A new incision design is presented. This flap design is carried out within keratinized gingiva. Limiting the flap design to keratinized tissue facilitates flap closure and avoids wound dehiscence.

Simplified transfer of intraoral bone grafts in ridge-augmentation procedures.

The use of mandibular symphyseal bone in bony reconstruction of limited anterior defects is common. This communication suggests the use of a template to ensure accurate sizing of the graft. A technique is also suggested where the screw hole in the grafted bone is made prior to the removal from the donor site. These modifications greatly simplify the transfer of bone grafts in these cases.

Mandibular Bone Graft Material for Reconstruction of Alveolar Cleft Defects: Long-Term Results

Abstract Objective: To analyze the long-term effect of mandibular bone as donor material in bone grafting of the alveolar process defect in patients with unilateral cleft lip and palate (UCLP), compared with iliac crest cancellous bone. Method: During a 7-year period, 101 UCLP patients were bone grafted, 57 cases with iliac crest cancellous bone and 44 with mandibular symphyseal bone. The long-term results with an observation time of more than 4 years were analyzed with respect to marginal bone level and dental and gingival condition in the grafted area. Complications were recorded. Results: The bone level in the grafted area was satisfactory in both groups. Impaction of cleft-side canines was found in 35% of the patients in both groups. Patients with agenesis of the cleft side lateral incisor had significantly more impacted canines, compared with patients with a cleft-side lateral situated in the lesser maxillary segment, probably due to the fact that the lateral incisors help in guiding the canine down ...

Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts

This article shows the usefulness of the mandibular symphysis as a source of bone graft for the reconstruction of the orbital floor. A retrospective study was conducted on 16 patients who had isolated blowout fractures (n = 10) or orbital floor defects (n = 6) reconstructed with mandibular symphyseal bone grafts. Symphyseal bone grafts were used when the defects were less than 2 cm in diameter. Patients were examined at recall visits for any evidence of unsuccessful reconstruction by checking extraocular movements, and evidence of diplopia or enophthalmous. During a mean follow-up of 12 months (range, 9 to 36 months), patients had no postoperative complaints. There were no instances of infection at the surgical sites, and none of the grafts were extruded or lost. There was good restoration of the orbital floor, with no clinical evidence of enophthalmous or diplopia. Extraocular movements were intact in all patients. The mandibular symphysis is a readily available source of autogenous bone that can be harvested with minimal morbidity. Its contour is suitable for use in orbital floor reconstruction. It merits consideration when autogenous bone grafts are considered for orbital floor defects less than 2 cm in diameter.

Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts

Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts

Ectomesenchymal mandibular symphysis bone graft: an improvement in alveolar cleft grafting?

Bone grafting the alveolar cleft in cleft lip and palate (CLP) patients is widely accepted. A traditional graft is the iliac crest. Other bone graft donor sites are briefly discussed. The ratio for an ectomesenchymal bone graft in alveolar cleft repair is explained. Aspects of the embryology, bone graft physiology, and reports on mandibular symphysis bone grafting are discussed.

Reconstruction of residual alveolo-palatal bone defects in cleft patients: A retrospective study

The results of reconstruction of residual alveolo-palatal bone defects in 40 patients are evaluated clinically and radiographically in a retrospective study. Age at the time of surgery varied from 7.4 to 32.7 years. The patients were divided into two age groups: before and after 12 at the time of operation. Free autogenous anterior iliac crest bone grafts were used in 26 patients and free autogenous mandibular symphyseal bone grafts were used in 14 patients. The results show unsuccessful closure of the oronasal communication in the alveolo-palatal area of the cleft in 3 out of 31 patients. In 3 out of 40 patients, radiographic incorporation of the bone graft was unsuccessful. The radiographic success was not related to increasing experience of the surgeons. The study indicates that the best grafting results are achieved when grafting is performed before 12 years of age. The radiographic results of mandibular symphyseal bone grafts tend to be slightly better compared with results obtained with anterior iliac crest bone.

The use of mandibular symphyseal bone in maxillofacial surgery

Mandibular symphyseal bone (MSB) is useful in alveolar cleft grafting and orthognathic surgery. This paper reports on the application and techniques using MSB.

Reconstruction of alveolar clefts with mandibular or iliac crest bone grafts: A comparative study

Bone grafting of alveolar cleft defects (ACD) in patients with cleft palate is now a common practice. It is generally agreed that an autograft is superior to an allogenic graft or alloimplant for reconstruction of an ACD. Sindet·Pedersen and Enemark tried to compare results ofreconstruction of the ACD using grafts of iliac crest bone (ICB) and mandibular symphyseal bone grafts (MBG). They state that observed levels of marginal bone in the cleft related to teeth were similar in the two groups, but this study has other variables that might affect their observations as well. These factors are: