title: Evaluation of the autogenous bone block transfer for dental implant placement: Symphysal or ramus harvesting?
abstract: BACKGROUND
  The absence of sufficient bone volume is the most relevant problem in implant dentistry. Grafting from exogenous sources may provide a limited gain but exhibits poor performance in large bone defects. Autogenous bone block transfer (ABBT) from the mandibular symphysis and ramus has been used with varying rates of success. The aim of this study was to compare the efficacy of symphysal and ramus ABBT for the restoration of lost horizontal alveolar bone volume in the anterior maxilla. Implants placed in the augmented areas were also evaluated.
  
  
  METHODS
  The maxillary alveolar bone deficits of 32 patients were treated by similar-sized autogenous bone blocks (7 × 7 × 4 mm) harvested from the symphysis or ramus area. After 4 to 5 months of healing, implants were inserted. At the end of the osseointegration period, the implants were restored by fixed prostheses. Baseline bone thickness was determined by Cone beam computed tomography and was compared to post-op and one-year post-loading bone thickness values where the implants were inserted. Any complications or consequences were noted. The success and survival of the 45 implants were evaluated. The results were analyzed using the Student t-test and Fisher's exact test (p < 0.05).
  
  
  RESULTS
  Post-op complications were frequent in both groups. Baseline bone thickness values were similar at the beginning of the study (p = 0.71) and exhibited a significant increase after the ABBT surgery (6.29 (SD 0.86) and 6.01 (SD 0.92) mm in the symphysis and ramus groups, respectively). The amount of bone thickness gain was 4.34 mm (SD: 0.92) and 4.36 mm (SD: 1.01) in the symphysis and ramus groups, respectively. After one year, the mean surface resorption was 0.6 mm (SD: 0.78) and 0.80 mm (SD: 0.56) for the symphysis and ramus groups, respectively (p = 0.089). The success and survival rates of the implants were 94.11 and 96.42 %, respectively. No graft failures were observed.
  
  
  CONCLUSIONS
  Both symphysal and ramus ABBT procedures were successful for the restoration of a horizontal bone defect in the anterior maxilla. Ramus harvesting may be advisable due to fewer complications. Implants placed in the grafted regions exhibited a high success and survival rate within the one-year follow-up period.
authors.affiliation: Department of Oral Impantology, Faculty of Dentistry, Istanbul University, 34093-Capa, Istanbul, Turkey. selimersanli@gmail.com.
authors.forename: Selim
authors.initials: S
authors.lastname: Ersanli
authors.affiliation: Department of Oral Impantology, Faculty of Dentistry, Istanbul University, 34093-Capa, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Arısan
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, 34088-Florya, Istanbul, Turkey.
authors.forename: Elçin
authors.initials: E
authors.lastname: Bedeloğlu
mesh_terms: D000540:Alveolar Ridge Augmentation; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D005500:Follow-Up Studies; D006801:Humans; D008437:Maxilla / Q000601:surgery
chemical_list: D015921:Dental Implants
references.citation: Clin Orthop Relat Res. 1996 Mar;(324):55-65
references.pmid: 8595778
references.citation: Int J Oral Maxillofac Implants. 1997 Nov-Dec;12(6):767-76
references.pmid: 9425757
references.citation: Periodontol 2000. 1996 Jun;11:85-94
references.pmid: 9567960
references.citation: Dentomaxillofac Radiol. 2008 Jan;37(1):10-7
references.pmid: 18195249
references.citation: Implant Dent. 2008 Mar;17(1):40-50
references.pmid: 18332757
references.citation: Med Oral Patol Oral Cir Bucal. 2009 Aug;14(8):e402-7
references.pmid: 19415058
references.citation: Int J Oral Maxillofac Surg. 2009 Oct;38(10):1059-65
references.pmid: 19632815
references.citation: Clin Oral Implants Res. 2010 Mar;21(3):296-307
references.pmid: 20443792
references.citation: Med Oral Patol Oral Cir Bucal. 2011 Mar;16(2):e210-4
references.pmid: 21196887
references.citation: Clin Oral Implants Res. 2012 Mar;23(3):340-50
references.pmid: 22092302
references.citation: Clin Oral Implants Res. 2012 Sep;23(9):1012-21
references.pmid: 22092480
references.citation: J Craniomaxillofac Surg. 2012 Dec;40(8):654-9
references.pmid: 22137760
references.citation: Int J Oral Maxillofac Implants. 2012 Nov-Dec;27(6):1481-93
references.pmid: 23189300
references.citation: Int J Oral Maxillofac Implants. 2013 Jan-Feb;28(1):222-7
references.pmid: 23377069
references.citation: Implant Dent. 2013 Dec;22(6):566-71
references.pmid: 24185462
references.citation: Int J Oral Maxillofac Implants. 2014;29 Suppl:55-77
references.pmid: 24660190
references.citation: Int J Oral Maxillofac Surg. 2014 May;43(5):626-32
references.pmid: 24411276
references.citation: J Oral Maxillofac Surg. 2014 Jun;72(6):1226.e1-15
references.pmid: 24831940
references.citation: J Craniomaxillofac Surg. 2014 Jul;42(5):e217-23
references.pmid: 24269641
references.citation: Eur J Oral Implantol. 2014 Summer;7(2):153-71
references.pmid: 24977250
references.citation: Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S203-17
references.pmid: 24977256
references.citation: J Craniofac Surg. 2014 Nov;25(6):e543-6
references.pmid: 25364976
references.citation: Clin Oral Investig. 2014 Dec;18(9):2203-11
references.pmid: 24562699
references.citation: Implant Dent. 2000;9(1):67-75
references.pmid: 11307236
references.citation: Int J Oral Maxillofac Implants. 2002 Mar-Apr;17(2):238-48
references.pmid: 11958407
references.citation: Scand J Plast Reconstr Surg. 1980;14(1):1-12
references.pmid: 6992262
references.citation: Int J Oral Maxillofac Implants. 1986 Summer;1(1):11-25
references.pmid: 3527955