Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

CLINICAL USAGES OF RAMAL AUTOGENOUS BONE GRAFTS IN DENTAL IMPLANT SURGERY

임플란트 식립 수술시 하악지 자가골이식술의 임상적 활용

  • Kim, Kyoung-Won (Department of Oral and Maxillofacial Surgery, College of Medicine & Medical Research Institute, Chungbuk National University) ;
  • Lee, Eun-Young (Department of Oral and Maxillofacial Surgery, College of Medicine & Medical Research Institute, Chungbuk National University)
  • 김경원 (충북대학교 의과대학, 의학연구소 치과학교실(구강악안면외과)) ;
  • 이은영 (충북대학교 의과대학, 의학연구소 치과학교실(구강악안면외과))
  • Published : 2008.05.30
Download PDF
⟨ Previous Next ⟩

Abstract

Dental endosseous implants require sufficient alveolar bone volume and quality for complete bone coverage and initial stability. But, atrophy or resorption of alveolar bone height and width according to patient's age and period of tooth loss can prevent ideal implant placement. Bone graft procedure has been proposed before or simultaneously with the placement of dental implants in patients with insufficient alveolar bone volume. While allografts, xenografts, and alloplastic bone grafts have been proposed and studied for alveolar ridge augmentation, the use of autogenous bone grafts represents the 'gold standard' for bone augmentation procedures. Conventional bone grafts are usually harvested from distant sites such as the ilium or ribs. Recently there is a growing use of intraoral bone grafts from intraoral donor sites such as mandibular symphysis, mandibular ramus and maxillary tuberosity. We recommend that the mandibular ramus is a safe autogenous bone graft donor site for bone harvesting with low morbidity. We report various effective autogenous bone graft procedures from mandibular ramus for the implant placement on various atrophic alveolar ridges.

저자들은 잔존 치조골의 흡수 및 위축으로 통상적인 임플란트 시술이 어려운 증례에서 하악골의 하악지에서 자가골을 채취하여 이를 증례에 따라 블록형 혹은 입자형으로 골 이식술을 시행하여 다양한 증례에 적용하여 비교적 만족할 만한 임플란트 식립 수술이 가능하였던 바 이를 문헌고찰과 함께 보고하며, 본 연구에서는 다양한 술식의 임상적 활용에 대해서만 보고하였으나 향후 이러한 증례들에 대하여 보다 장기적인 추적조사와 골 이식된 부위의 골 조직의 재형성 식립된 임프란트의 보철적인 기능과 장기적인 예후에 대한보다 체계적인 연구가 필요하리라 사료된다.

Keywords

References

  1. Adell R, Eriksson B, Lekholm U et al : Long-term followup study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 5 : 347, 1990
  2. Jemt T, Lekholm U, Adell R : Osseointegration in the treatment of partially edentulous patients: A preliminary study of 876 consecutively installed fixtures. Int J Oral Maxillfac Implants 4 : 211, 1989
  3. Lorenzetti M, Mozzati M, Campanino PP et al : Bone augmentation of the inferior floor of the maxillary sinus with autogenous bone or composite bone graft: A histologic-histomorphometric preliminary report. Int J Oral Maxillofac Implants 13 : 69, 1998
  4. Merkx MAW, Maltha JC, Stoelinga PJW : Assessment of the value of anorganic bone additives in sinus floor augmentation: A review of clinical reports. Int J Oral Maxillofac Surg 32 : 1, 2003 https://doi.org/10.1054/ijom.2002.0346
  5. Zijderveid SA, Zerbo IR, van den Bergh JPA et al : Maxillary sinus floor augmentation using a $\beta$-tricalcium phosphate (Cerasorb) alone compared to autogenous bone grafts. Int J Oral Maxillofac Implants 20 : 432, 2005
  6. Karl AS, Gabriele F, Stefan SM et al : Histologic findings in sinus augmentation with autogenous bone chips versus a bovine bone substitute. Int J Oral Maxillofac Implants 18 : 53, 2003
  7. Periklis P, Jaime L, Alejandro K et al : The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: A pilot study. Int J Oral Maxillofac Implants 17 : 238, 2002
  8. Schwarts-Arad D, Levin L et al : Intraoral autogenous block onlay bone grafting for extensive reconstruction of atrophic maxillary alveolar ridges. J Periodontol 76 : 636, 2005 https://doi.org/10.1902/jop.2005.76.4.636
  9. Iturriaga MT, Ruiz CC : Maxillary sinus reconstruction with calvarium bone grafts and endosseous implants. J Oral Maxillofac Surg 62 : 344, 2004 https://doi.org/10.1016/j.joms.2003.08.013
  10. Giovanna O, Andrea EB, Raffaele V et al : Histologic evaluation of autogenous calvarial bone in maxillary onlay bone grafts: A report of 2 cases. Int J Oral Maxillofac Implants. 18 : 594, 2003
  11. Le Lorc'h-Bukiet I, Tulasne JF, Llorens A et al : Parietal bone as graft material for maxillary sinus floor elevation: structure and remodeling of the donor and of recipient sites. Clin Oral Implants Res 16 : 244, 2005 https://doi.org/10.1111/j.1600-0501.2004.01102.x
  12. Proussaefs P : Clinical and histologic evaluation of the use of mandibular tori as donor site for mandibular block autografts: report of three cases. Int J Periodontics Restorative Dent 26 : 43, 2006
  13. Misch CM : Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 12 : 767, 1997
  14. Montazem A, Valauri DV, St-Hilaire H et al : The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 58 : 1368, 2000 https://doi.org/10.1053/joms.2000.18268
  15. Silva FM, Cortez AL, Moreira RW et al : Complications of intraoral donor site for bone grafting prior to implant placement. Implant Dent 15 : 420, 2006 https://doi.org/10.1097/01.id.0000246225.51298.67
  16. Joshi A : An investigation of post-operative morbidity following chin graft surgery. Br Dent J 196 : 215, 2004 https://doi.org/10.1038/sj.bdj.4810987
  17. von Arx T, Hafliger J, Chappuis V : Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study. Clin Oral Implants Res 16 : 432, 2005 https://doi.org/10.1111/j.1600-0501.2005.01138.x
  18. Clavero J, Lundgren S : Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications. Clin Implant Dent Relat Res 5:154, 2003 https://doi.org/10.1111/j.1708-8208.2003.tb00197.x
  19. Gungormus M, Yavuz MS : The ascending ramus of the mandible as a donor site in maxillofacial bone grafting. J Oral Maxillofac Surg 60 : 1316, 2002 https://doi.org/10.1053/joms.2002.35731
  20. Nkenke E, Radespiel-Troger M, Wiltfang J et al : Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Implants Res 13 : 513, 2002
  21. Hendy CW, Smith KG, Robinson PP : Surgical anatomy of the buccal nerve. Br J Oral Maxillofac Surg 34 : 457, 1996 https://doi.org/10.1016/S0266-4356(96)90108-4