Imaging Sci Dent.  2013 Sep;43(3):135-143. 10.5624/isd.2013.43.3.135.

Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

Affiliations
  • 1Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome, Italy. andrea.cicconetti@uniroma1.it
  • 2Dr. Coronelli Dental Clinic, Rome, Italy.

Abstract

PURPOSE
This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness.
MATERIALS AND METHODS
This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L).
RESULTS
The cortical volume was 0.71+/-0.23 mL (0.27-1.96 mL) and the cancellous volume was 2.16+/-0.76 mL (0.86-6.28 mL). The minimal cortical vestibular thickness was 1.54+/-0.41 mm (0.61-3.25 mm), and the maximal cortical vestibular thickness was 3.14+/-0.75mm(1.01-5.83 mm).
CONCLUSION
The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

Keyword

Grafting, Bone; Cone-Beam Computed Tomography; Bone Density; Bone Resorption

MeSH Terms

Bone Density
Bone Resorption
Bone Transplantation
Cone-Beam Computed Tomography
Cuspid
Evaluation Studies as Topic
Humans
Tissue Donors
Tooth
Transplants

Figure

  • Fig. 1 This graph shows the patients' age distribution in this study.

  • Fig. 2 The pictures show the procedure of the identification of the mental region. A. The lateral limits are defined as 5 mm in front of the medial margin of each mental foramen. B. The upper limit is defined as 5 mm under the apex of each tooth present and the lower as the upper part of the inferior mandibular cortex.

  • Fig. 3 A. Cortical bone (yellow) and cancellous bone (green) are defined on the cross-sectional image. B. Three cross-sections are determined at the right canine tooth (3R), median section (M), and left canine tooth (3L). C. The minimal and maximal cortical thickness are measured on the cross-section at the left canine tooth.

  • Fig. 4 The bone volume (A) and Hounsfield density (B) of the cortical/cancellous bone.

  • Fig. 5 The cortical plate thickness at the right canine tooth, median section, and left canine tooth.

  • Fig. 6 The cortical/cancellous bone volume (A) and Hounsfield density (B). (The cases are arranged in order of age and linear trend lines have been drawn.) A. The average lines and linear trend lines coincide and are superimposed, as the volumes of the cortical and cancellous bone did not depend on the patients' age (19-91) in the considered range. B. The Hounsfield densities of the cortical and cancellous bone show an age-related pattern. The cancellous bone density increases with age, while the cortical bone density decreases.

  • Fig. 7 Cortical and cancellous bone. A. The harvestable bone is highlighted. B. The cortical and cancellous bone is rendered as a 3D image.


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