Localized ridge augmentation with autogenous onlay graft before implant insertion

Kasama Aryatawong, Asst. Prof., D. of Surgery, F. of Dentistry, PSU.
E-mail : akasama@ratree.psu.ac.th

Presented : The 4th Asian Congress on Oral and Maxillofacial Surgery, 6-10 June,2000 The Shilla Cheju, Cheju Island, Korea.
Published : Asian J Oral Maxillofac Surg. 2000; 12 (Suppl.1); 73
Key words : bone grafting, dental implant, ridge augmentation

The clinical outcome of surgical reconstruction for the narrow edentulous ridges before im- plant installation in 23 patients was evaluated. Under local anesthesia corticocancellous block grafts were harvested from the retromolar area and were rigidly fixed to 25 recipient sites with titanium microscrews. No barrier membrane was used. Complications following the procedure, either at donor or recipient sites,were recorded. Endosseous implants were placed secondarily following a 4 to 6 month healing period. At this time the gain of ridge width obtained was measured.

Complications encountered were wound dehiscence of 3 recipient sites (12%) which required surgical recontouring and closure, wound rupture followed by pus formation at 4 donor sites and transient sensory disturbance in two patients(8.7%). The average amount of bone gain was 3.1 mm. The onlay grafts exhibited minimal resorption and maintained their dense quality. All 52 implants placed achieved primary stability, but three failed (5.8%) at second stage surgery.

Autologous block grafts can be used successfully to improve the ability to place endosseous implants. The retromolar area provides essentially a cortical graft that is well suited for veneering ridge deficiencies. This method is a reliable procedure for the correction of narrow ridges with low morbidity. There is no need for the use of the barrier membrane which increases the cost of the procedure.

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