Evaluation of the Zygomatic Buttress as a Donor Site for Ridge Augmentation Prior to Implant Insertion in the Esthetic Zone

Abstract

INTRODUCTION: Traumatic loss of teeth in the esthetic zone commonly results in significant loss of buccal bone. This leads to reduced esthetics, problems with phonetics and reduction in function. Single tooth replacement has become an indication for implant-based restoration. In case of lack of bone volume the need of surgical reconstruction of the alveolar ridge is warranted. Several bone grafting techniques have been described to ensure sufficient bone volume for implantation. OBJECTIVES: Evaluation of using the zygomatic buttress as an intraoral bone harvesting donor site for pre-implant grafting. MATERIALS AND METHODS: Twelve patients were selected with limited alveolar ridge defect in the esthetic zone that needs bone grafting procedure prior to dental implants. Patients were treated using a 2-stage technique where bone blocks harvested from the zygomatic buttress region were placed as onlay grafts and fixed with osteosynthesis micro screws. After 4 months of healing, screws were removed for implant placement RESULTS: Harvesting of 12 bone blocks were performed for all patients indicating a success rate of 100% for the zygomatic buttress area as a donor site. Final rehabilitation with dental implants was possible in 11 of 12 patients, yielding a success rate of 91.6%. Three patients (25%) had postoperative complications at the donor site and one patient (8.3%) at the recipient site. The mean value of bone width pre-operatively was 3.64 ± .48 mm which increased to 5.47 ± .57 mm post-operatively, the increase in mean value of bone width was statistically significant (p < 0.001). CONCLUSIONS: Harvesting of intraoral bone blocks from the zygomatic buttress region is an effective and safe method to treat localized alveolar ridge defect before implant placement.

The Zygomatic Buttress as an Efficient Intraoral Donor Site for Limited Maxillary Reconstructions: A Case Series and Brief Literature Review

“…A study on ten cases reported a mean horizontal bone gain of 1.82 ± 0.16 mm, 4 months after grafting with bone harvested from the ZB. These grafted sites showed similar bone density values to those of the native alveolar bone [ 7 ]. This ZB also offers bone of good quality and correct convex morphology for maxillary defects.…”