Mandibular anatomy as it relates to rigid fixation of the sagittal ramus split osteotomy

Smith, Brian R.; Rajchel, Jeffrey L.; Waite, Daniel E.; Read, Lance

doi:10.1016/0278-2391(91)90209-5

Cited by 30 publications

(15 citation statements)

References 13 publications

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“…In only one case was the width of the alveolar shelf insufficient for bone harvesting with a trephine drill of 10 mm in diameter. The average value of 14.2 ± 1.9 mm (minimum 10 mm, maximum 17 mm) was in good accordance with previous trials (Smith et al. 1991).…”

Section: Discussionsupporting

confidence: 91%

“…During the follow‐up, impairment of the superficial sensory function of the inferior alveolar nerve was not observed in the present study, although it has been described previously (Von Arx & Kurt 1998). It is generally accepted that cutting 10 mm deep in a vertical direction in the retromolar region leaves the inferior alveolar nerve untouched (Smith et al. 1991).…”

Section: Discussionmentioning

confidence: 99%

“…However, because of the typical configuration of the alveolar shelves, perforations cannot be avoided reliably. Anatomical trials show that the mandibular base is 5 mm smaller than the alveolar shelf on average (Smith et al. 1991).…”

Section: Discussionmentioning

confidence: 99%

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Morbidity of harvesting of retromolar bone grafts: a prospective study

Nkenke¹,

Radespiel‐Tröger²,

Wiltfang³

et al. 2002

Clinical Oral Implants Res

239

185

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20 retromolar bone grafts were harvested in outpatients for augmentation of the implant site from January to June 2000 (10 female, 10 male, 40.9 +/- 12.8 years, minimum 17 years, maximum 66 years). The aim of the study was to assess typical complications of this procedure in a prospective manner. For the determination of the superficial sensory function of the inferior alveolar and the lingual nerve, an objective method was used. The bone grafts were harvested for single tooth reconstruction. In 14 cases a ridge augmentation and in 6 cases an endoscopically controlled crestal sinus floor elevation was performed. Preoperatively, the height of bone above the cranial aspect of the inferior alveolar nerve in the retromolar region was assessed radiologically with known markers. The maximum mouth opening was determined. The superficial sensory function of the inferior alveolar and the lingual nerve was assessed with the Pointed-Blunt Test, the Two-Point-Discrimination Test and the objective method of the 'Pain and Thermal Sensitivity' Test (PATH Test). Moreover, the pulp sensitivity of the teeth of the donor site was determined by cold vitality testing. All tests were repeated 1 week postoperatively. Intraoperatively, the width of the retromolar region was measured with a caliper. The patients rated the operative strain on a visual analogue scale. The height of bone above the inferior alveolar nerve in the retromolar region was 11.0 +/- 2.2 mm. The width of the retromolar area was 14.2 +/- 1.9 mm. Postoperatively, the maximal mouth opening changed significantly (40.8 +/- 3.5 mm preoperatively, 38.9 +/- 3.7 mm postoperatively, P = 0.006). However, the reduction was not relevant clinically. A direct injury of the inferior alveolar or lingual nerve did not occur. A sensitivity impairment could not be detected for either of the nerves by the different test methods 1 week postoperatively. The operative strain related to the donor site was significantly less than the strain generated by the implant placement (rating on a visual analogue scale 2.8 +/- 1.0 and 4.1 +/- 2.0, respectively, P = 0.027). Retromolar bone grafts are a viable method for augmentation of the implant site in conjunction with single tooth reconstruction with low strain on the patient and minimal risk of complications.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Morbidity of harvesting of retromolar bone grafts: a prospective study

Nkenke¹,

Radespiel‐Tröger²,

Wiltfang³

et al. 2002

Clinical Oral Implants Res

239

185

View full text Add to dashboard Cite

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“…These results demonstrate the degree of lingual undercut. These results are in keeping with a previous study 30 , which found that the thickness of the basal bone was 5 mm less on average than the thickness of the crest in posterior regions of the mandible. A number of reported complications can occur following the harvesting of intraoral bone grafts 19,20,29 .…”

Section: Discussionsupporting

confidence: 93%

A radiographic analysis of anatomical variation at the mandibular sites of intraoral bone harvesting

et al. 2017

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Objectives Intraoral bone grafting is an important component of implant treatment, but also a source of intra‐ and post‐operative complications. This study sought to determine the relationship of bone surface to underlying nerves and vasculature, at the two most commonly employed intraoral sites for bone harvesting. Materials and Methods Data were collected by direct measurement of 103 potential graft sites (50 retromolar sites: 53 symphyseal sites) of patients undergoing CT scanning for implant surgery assessment. Results Symphyseal analysis included 26 female and 27 male patients. Data recorded were as follows: maximal width of the mandible between lower central incisor root tips (mean: 13.7 mm; range: 11.3–16.4 mm), maximal width of the mandible below the canine tip (mean: 11.5 mm; range: 7.7–14.9 mm), tip of canine to mandibular incisive nerve (mean: 4.3 mm; range: 1.2–8.9 mm), canine root tip to outer labial cortex (mean: 4.0 mm; range: 1.9–7.3 mm) and midline distance from the incisive nerve to outer labial cortex (mean: 3.0 mm; range: 1.0–6.9 mm). Retromolar analysis comprised of 33 female and 17 male patients. Data recorded included distance from inferior dental canal to the outer buccal cortex (mean: 3.2 mm; range: 1.0–7.9 mm), the most buccal point of the lower second molar roots to the outer buccal cortex (mean: 3.3 mm; range: 1.0–6.5 mm) and thickness of the mandibular crest at the lower second molar (mean: 13.8; range: 10.2–18.2 mm). Conclusions The proximity of underlying vital structures may be easily overlooked in routine examination of implant patients and may be related to patient characteristics.

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“…It was reported that a rectangular piece of cortical bone, ∼3.0 to 5.0 mm in thickness, can be harvested from the mandibular ramus 2 . Meanwhile, the cortical bone thickness in the retromolar area of the mandible was quantified to be ∼3.0 to 3.5 mm 8 . The thickness of the mandible at the external oblique ridge is even greater: 7.0 to 17.8 mm (mean, 13.3 to 14.9 mm).…”

Section: Discussionmentioning

confidence: 99%