title: Bone grafting with granular biomaterial in segmental maxillary osteotomy: A case report.
abstract: BACKGROUND
  Segmental maxillary osteotomy enables correction of anterior open bites. However, the outcome can be somewhat unstable, particularly if pseudarthrosis occurs. Bone grafts can be used to prevent this complication. Among the many biomaterials available for grafting, Bio-oss(®) has been used successfully in a range of modalities, with studies to support several indications. This report describes a case of segmental maxillary osteotomy in which Bio-oss(®) granules were used as bone grafts in the surgical gap.
  
  
  METHODS
  A 24-year-old female presented with anterior open bite, Angle class III posterior occlusion, and Angle class II anterior occlusion. Virtual surgical planning of the procedure predicted a gap of approximately 5mm in the region of the osteotomy, which was bridged with Bio-oss(®) granules.
  
  
  CONCLUSIONS
  Although autogenous bone grafting is the gold standard due to its osteoconductive, osteoinductive, and osteogenic properties, it involves increased morbidity for the patient, unpredictable resorption rates, increased operative time, and risk of infection at the donor site. Use of the Bio-oss(®) material can provide good bone stability, osteoconduction, and biocompatibility, while reducing operative time and surgical morbidity.
  
  
  CONCLUSIONS
  This is the first report of bone grafting with a granular biomaterial in segmental maxillary osteotomy. Successful formation of new bone with density greater than that of the surrounding tissue was achieved, preventing pseudarthrosis and postoperative instability.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Orion Luiz
authors.initials: OL
authors.lastname: Haas Junior
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil. Electronic address: lcsmeirelles@hotmail.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: da Silva Meirelles
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Neimar
authors.initials: N
authors.lastname: Scolari
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Otávio
authors.initials: O
authors.lastname: Emmel Becker
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fernandes Santos Melo
authors.affiliation: Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul - PUC/RS, Av. Ipiranga, n.6681, Building 6, 91530-001 Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Belle de Oliveira
keywords: Computer-assisted surgery; Orthognathic surgery; Synthetic bone substitute; Virtual planning