The mandibular symphysis as a donor site in maxillofacial bone grafting: A quantitative anatomic study

Montazem, André H.; Valauri, David V.; St-Hilaire, Hugo; Buchbinder, Daniel

doi:10.1053/joms.2000.18268

Cited by 102 publications

(91 citation statements)

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“…Mandibular symphysis bone graft has been used widely for alveolar repair to allow implant placement with extremely favorable results [10,11,12] and the same is also used for maxillary sinus floor augmentation [13,14] This source is, however, often overlooked when an autogenous bone graft is needed for orbital floor reconstruction. This bone graft can be harvested with relative ease and low morbidity such bone grafts can be used to repair defects measuring upto 2 cm in diameter.…”

Section: Resultsmentioning

confidence: 99%

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

Rudagi

Halli

Mahindra

et al. 2009

J. Maxillofac. Oral Surg.

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Objective The present study aimed to evaluate and analyze postoperative results of Autogenous Mandibular Symphysis graft material for orbital floor reconstruction. Material and methods 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. Results 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. Conclusion 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.

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Section: Resultsmentioning

confidence: 99%

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

Rudagi

Halli

Mahindra

et al. 2009

J. Maxillofac. Oral Surg.

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“…Li & Schwartz (1996) determinaron que era posible obtener injerto de cuerpo mandibular próximos a los 13mm de largo y 3mm de ancho, posibilitando su uso también en estos grupos. Montazem et al (2000) evaluaron el volumen óseo que puede ser obtenido de sínfisis mandibular, respetando los límites que impidan lesión dentaria o nerviosa (nervio mental) en 16 cadáveres, estableciendo un promedio de 4,84cm3, lo cual implica que puede ser empleado en los casos de mayor aumento óseo y en casos de reconstrucción osea intra sinusal bilateral.…”

Section: Discussionunclassified

Estudio Morfométrico del Seno Maxilar Mediante Tomografías Computadorizadas: Evaluación de la Reconstrucción Total de Piso Sinusal

et al. 2012

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del seno maxilar mediante tomografías computadorizadas. Evaluación de la reconstrucción total de piso sinusal. Int. J. Morphol., 30(2):592-598, 2012. RESUMEN:La rehabilitación con implantes dentales en maxila posterior es compleja debido a la presencia del seno maxilar con sus diferentes variaciones anatómicas; el objetivo de este trabajo fue determinar el volumen óseo intrasinusal necesario para realizar la instalación de uno o mas implantes dentarios sin invadir la membrana sinusal. En 22 cráneos fueron evaluados 40 senos maxilares mediante tomografías computadorizadas (TC) realizando mediciones en los cortes axiales, coronales y sagitales. Se clasificaron los senos maxilares según el remanente de hueso alveolar y se instalo un implante de forma virtual en el lugar del primer molar superior, mediante el software implant view. Con estas medidas volumétricas finales se estableció las indicaciones reconstructivas intra sinusales a partir de los sitios donantes intrabucales mas frecuentemente evaluados en la literatura mundial. El grupo I (1mm a 4mm de reborde alveolar remanente) presentaba déficit óseo de hasta 1,98cm3, el grupo II (4mm a 7mm) presentaba déficit de 1,06cm3; el grupo III (7mm a 10mm) presentaba un déficit de 0,67 cm3; a partir de estos resultados podemos concluir que los sitios intrabucales pueden ser utilizados en la mayoría de los grupo estudiados, incluyendo las reconstrucciones bilaterales.PALABRAS CLAVE: Seno maxilar; Elevación de seno maxilar; Reconstrucción ósea. INTRODUCCIÓNEn maxila posterior edéntula existen limitaciones anatómicas para la instalación de implantes oseointegrados, destacando la deficiencia ósea en términos del volumen del hueso alveolar remanente y la presencia del seno maxilar, de mayor volumen en pacientes edéntulos; en estos casos, la alternativa de rehabilitación se asocia a la instalación de implantes con diseños modificados, lo cual presenta algunas limitaciones (Olate et al. 2010) y la reconstrucción ósea parcial de forma previa a la instalación de implantes (Raghoebar et al. 1997).En 1980, Boyne & James, realizaron una de las primeras publicaciones abordando la cirugía destinada al trasplante óseo a través de una ostectomia realizada en la pared lateral del seno maxilar; el injerto óseo en forma de partícu-las era instalado dentro del seno maxilar, posterior al descolamiento de la mucosa sinusal, lo que permitía la integración ósea intrasinusal.El hueso autógeno es el patrón de oro en la reconstrucción ósea, que, aplicado antes o durante la instalación de implantes oseointegrados, optimiza los tratamiento y mejora los resultados estéticos y funcionales (Olate et al. 2007a), siendo el único material capaz de entregar las propiedades osteoconductivas, osteoinductivas y osteogénicas (Becker et al., 1995, Johansson et al., 2010. De esta forma, la obtención de estos injertos se realiza a partir de la sínfisis mandibular, rama mandibular, proceso coronoide, hueso palatino, hueso cigomático, parietal, epífisis de tibia y hueso de cresta iliaca, entre otras (Uchida et al...

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“…The harvesting procedure can be performed in the office or as an outpatient in the hospital. The decreased morbidity of local donor sites over distant sites and the use of a transoral approach, which does not result in a cutaneous scar, make this procedure more easily acceptable to the patient [5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy of Mandible and Iliac Bone as Autogenous Bone Graft for Orbital Floor Reconstruction

Garg¹,

Giraddi

Roy³

2014

J. Maxillofac. Oral Surg.

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Objective This study evaluated and compared the efficacy of mandible and iliac bone as autogenous bone graft for correction of orbital floor fractures. Patients and Methods Twenty patients who suffered orbital floor fractures took part in the study. The subjects enrolled in the study sustained both isolated orbital floor fracture and orbital floor fracture associated with fracture of zygomatico-maxillary complex. Each inferior orbital wall was reconstructed using either a mandible bone graft or an iliac graft. Mandibular symphysis was opted as a donor site for graft harvest from mandible and anterior iliac crest for the iliac group. CT scans were taken before the operation. Inclusion criteria consisted of at least 2 months postsurgical follow-up, pre-and post-surgical photographic documentation, and complete medical records regarding inpatient and outpatient data. To describe the distribution of complications and facilitate statistical analysis, we categorized our findings into diplopia, enophthalmos, and restriction of ocular movements before and after treatment.We also considered the time required for the harvest of the grafts and the donor site complications. A comparative study was carried out using Chi square test and student t test. We considered P value \0.05 to be statistically significant. Results Ten iliac crest grafts and ten mandible bone grafts were placed. The mean age of the patients was 33.1 years. 80 % of the patients were males. The most common complication of orbital floor fracture was diplopia, followed by enophthalmos and restriction of ocular movements. The post operative results were compared after 2 months of the surgery. In iliac crest group, diplopia got corrected in six out of seven patients (85 %), enophthalmos in four out of five patients (80 %) and restricted ocular movement showed 100 % correction. While in mandible group, diplopia and ocular movement showed 100 % correction and enophthalmos got corrected in five out of six patients (83 %). No statistically significant differences were found between the two groups on comparing these variables. On the other hand the mean time required for the harvest of iliac graft and mandible graft was 30.2 ± 3.52 min and 16.8 ± 1.75 min respectively. The difference was statistically significant. Conclusion There is no difference in the ability of mandible and anterior iliac crest bone grafts to correct posttraumatic diplopia, enophthalmos and restricted ocular movements. But the time and ease of harvest of the graft from mandible was comparatively less and easy especially when the treating doctor was an oral and maxillofacial surgeon. Secondly the post-operative morbidity was low and the quality and contour of the bone graft was very adaptable for the reconstruction of the orbital floor.

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The mandibular symphysis as a donor site in maxillofacial bone grafting: A quantitative anatomic study

Cited by 102 publications

References 12 publications

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

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

Estudio Morfométrico del Seno Maxilar Mediante Tomografías Computadorizadas: Evaluación de la Reconstrucción Total de Piso Sinusal

Comparison of Efficacy of Mandible and Iliac Bone as Autogenous Bone Graft for Orbital Floor Reconstruction

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