Particularities in the Surgical Technique of Calvaria Graft

Abstract

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.

Calcium Sulfate and Plasma Rich in Growth Factors Enhance Bone Regeneration after Extraction of the Mandibular Third Molar: A Proof of Concept Study

“…Extraorally, it can be taken from the iliac crest, femur, tibia, fibula, humerus or, ribs. However, this type of graft increases morbidity and requires longer surgical time [ 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. An allograft is taken from a bone bank (corpse tissue) and has osteoinductive and osteoconductive properties depending on how it is processed: frozen, freeze-dried (cold drying), freeze-dried-demineralized or bone irradiated [ 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 15 , 16 ].…”