Case Analysis Of Autogenous Bone Block Graft From Mandible Ramus With GBR For Maxillary Anterior Alveolar Ridges Defects

Objective: To investigate the clinical effect of maxillary alveolar bone augmentation with the methods of intraoral onlay autogenous bone grafts from mandible ramus in combination with guided bone regeneration(GBR)technique for the implantation.To observe the quantity of bone formation and the rate of bone resorption of the recipient bone site as well as the bone healing and reconstruction of the donor bone site(external oblique line of mandible ramus)via CBCT(Cone Bean CT).Method: From June 2015 to March 2017,a consecutive series of 5 patients with maxillary anterior alveolar bone atrophy were treated with intraoral autogenous block bone grafts in combination with GBR technique and delayed implant placement at least 6 months after augmentation.2 cases of men and women in 3 patients,all cases with contiguous multiple teeth loss,the maximum age 31,minimum age 20,mean age 25.We operated according to the surgery standard,protected the surrounding important organizational structures at the donor and at the recipient site,ensure the stability of block graft were fixed with titanium osteosynthesis screws and recording process in detail.Antibiotic prophylaxis and cold compresses should be given after the operation.Active follow-up in two weeks,a month,after six months.CBCT scans were performed preoperatively,immediately after augmentation,6 months after augmentation before implant placement.Result: Donor site: for all patients,no lower teeth paresthesia and lower lip numbness occurred.Postoperative wound healed well with no infection.Recipient site: Postoperative wound healed well.There was one case that a patient has an ulceration at the labial side.Gradually it was healed after symptomatic treatment.CBCT: preoperatively the alveolar bone width was 3.8mm in average.After the surgery,the width of alveolar bone increased 6.23 mm to 9.38 mm in six months.Mean bone resorption :6.5%.The success rate was 100%.Till March,2017,no adverse reaction occurred after the implantation.Conclusion: Within the limitations identified,the intraoral onlay autogenous bone grafts in combination with GBR technique can be considered as an effective and safe method to achieve maxillary alveolar bone augmentation success when contiguous maxillary anterior teeth are missing with insufficient of anterior alveolar ridges for teeth implantation.