J Korean Assoc Oral Maxillofac Surg.  2010 Oct;36(5):427-433.

A clinical study of iliac bone graft using subperiosteal tunneling method for alveolar ridge augmentation

• Park S
• Jung JH
• Kim YG
• Kwon YD
• Choi BJ
• Ohe JY
• Lee BS

Abstract

PURPOSE
The objective of this study was to evaluate the efficacy of the subperiosteal tunneling technique with iliac block bone graft for bone augmentation in an edentulous alveolar ridge.
PATIENTS AND METHODS
Total of 8 sites in 7 patients were included in this study. The bone height was evaluated by CBCT preoperatively and 4 months after operation. Total of 11 implants were inserted and evaluated clinically and radiographically.
RESULTS
Mean value of the increased bone height was 6.29 mm and no implant failure was observed. There were no complications such as soft tissue dehiscence, exposure of the grafted bone and infection.
CONCLUSION
We have achieved excellent clinical outcomes by this technique, so we concluded that it is useful for augmentation of severely deficient alveolar ridge.

Keyword

Iliac bone graft; Tunneling technique; Bone augmentation; Alveolar ridge; Bone resorption

MeSH Terms

Alveolar Process
Alveolar Ridge Augmentation
Bone Resorption
Humans
Transplants

Figure

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  Fig. 1. Preoperative panoramic view showing atrophic ridge on right edentulous mandibular molar area.

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  Fig. 2. Clinical photo of deficient right mandibular alveolar ridge.

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  Fig. 3. Preoperative 3 dimensional view conebeam computerized tomography (CBCT) scan showing the right mandibular alveolar ridge.

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  Fig. 4. Computed tomography (CT) scan showing deficient area before iliac bone graft. It shows close approximation to inferior alveolar nerve due to severe vertical alveolar bone resorption.

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  Fig. 5. Two vertical incisions are made.

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  Fig. 6. Dissection and formation of subperiosteal pocket using sharp periosteal elevator.

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  Fig. 7. Iliac corticocancellous block bone graft being inserted under the elevated subperiosteal pocket. Before insertion of the block, periosteal releasing incision was made with iris scissors. After insertion, the space between the recipient site and block was filled with bone chips mixed with FDBA (orthoblast II). (FDBA: freeze-dried bone allograft)

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  Fig. 8. Fixation of block bone with microscrew.

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  Fig. 9. Immediate postoperative view of the grafted alveolar ridge.

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  Fig. 10. Postoperative panoramic view showing grafted area of right posterior mandibular ridge.

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  Fig. 11. Postoperative conebeam computerized tomography (CBCT) scan after 4 months of healing of the graft showing augmented alveolar ridge on right posterior mandible.

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  Fig. 12. Two Implants were placed with more than 35 NCm torque on grafted sites with trans-gingival type fixture.

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  Fig. 13. The final prosthesis fabricated after 5 months of healing period of the implants in the graft.

Reference

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