title: Bifunctional sculpturing of the bone graft for 3-dimensional augmentation of the atrophic posterior mandible.
abstract: Short implant procedures may suffer from fixture instability, if incorrectly planned and performed, and from an esthetically compromised rehabilitation, due to increased interarch distance and increased crown-implant ratio. Several procedures have been proposed to achieve alveolar ridge augmentation with different success and complication rates: onlay grafts, alveolar sandwich osteotomies, titanium micromesh, alveolar distraction, and alveolar nerve transposition. The edentulous posterior mandible suffers from the presence of a compact cortical layer, which tends to limit graft osteogenesis, because of a low permeability to the osteogenic elements (microvessels and cells). This report introduces a variant to the endochondral onlay bone graft, in which an external cortical layer is placed above a biologically active core of cancellous bone and platelet-rich plasma. This solution provides easy 3-dimensional conformation of the graft, enhancing its mechanical stability. The presence of the biologically active core provides better vascular support and a valid interface between graft and the osteogenetic cell lines.
authors.affiliation: Department of Maxillo-Facial Surgery, University of Udine, Faculty of Medicine, Udine, Italy. francesco.polini@med.uniud.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Polini
authors.forename: Massimo
authors.initials: M
authors.lastname: Robiony
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sembronio
authors.forename: Fabio
authors.initials: F
authors.lastname: Costa
authors.forename: Massimo
authors.initials: M
authors.lastname: Politi
mesh_terms: D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D016025:Bone Transplantation / Q000379:methods*; D017267:Dental Prosthesis Design; D006085:Graft Survival; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000473:pathology / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*