A computer-guided bone block harvesting procedure: a proof-of-principle case report and technical notes

Int J Oral Maxillofac Implants. 2015 Nov-Dec;30(6):1409-13. doi: 10.11607/jomi.4045.

Abstract

During autogenous mandibular bone harvesting, there is a risk of damage to anatomical structures, as the surgeon has no three-dimensional control of the osteotomy planes. The aim of this proof-of-principle case report is to describe a procedure for harvesting a mandibular bone block that applies a computer-guided surgery concept. A partially dentate patient who presented with two vertical defects (one in the maxilla and one in the mandible) was selected for an autogenous mandibular bone block graft. The bone block was planned using a computer-aided design process, with ideal bone osteotomy planes defined beforehand to prevent damage to anatomical structures (nerves, dental roots, etc) and to generate a surgical guide, which defined the working directions in three dimensions for the bone-cutting instrument. Bone block dimensions were planned so that both defects could be repaired. The projected bone block was 37.5 mm in length, 10 mm in height, and 5.7 mm in thickness, and it was grafted in two vertical bone augmentations: an 8 × 21-mm mandibular defect and a 6.5 × 18-mm defect in the maxilla. Supraimposition of the preoperative and postoperative computed tomographic images revealed a procedure accuracy of 0.25 mm. This computer-guided bone harvesting technique enables clinicians to obtain sufficient autogenous bone to manage multiple defects safely.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alveolar Bone Loss / surgery
  • Alveolar Ridge Augmentation / methods
  • Autografts / transplantation*
  • Bone Transplantation / methods*
  • Computer-Aided Design
  • Dental Implantation, Endosseous / methods
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Mandible / surgery
  • Maxilla / surgery
  • Osteotomy / instrumentation
  • Osteotomy / methods
  • Patient Care Planning
  • Surgery, Computer-Assisted / methods*
  • Surgical Flaps / surgery
  • Tissue and Organ Harvesting / methods*
  • Tomography, X-Ray Computed / methods