Use of a trephine bur and curette for minimally invasive harvesting of particulate cancellous bone and marrow from the iliac crest: a case of alveolar ridge reconstruction

Int J Implant Dent. 2016 Dec;2(1):1. doi: 10.1186/s40729-015-0033-z. Epub 2016 Jan 4.

Abstract

Iliac particulate cancellous bone and marrow (PCBM) is still the most predictable autogenous graft material for vertical ridge reconstruction because of its high cell content as well as osteoinductive and osteoconductive properties. However, postoperative meralgia paresthetica, gait disturbance, pain, and bleeding have been reported following conventional harvesting from the anterior iliac crest. We present a case of minimally invasive harvesting of iliac PCBM. A short incision was made, and the iliac crest was exposed after elevation of the periosteal membrane. Only the iliac cortical bone was removed using a trephine bur to avoid perforation. PCBM was harvested with hand curettes and grafted into the vertical ridge defect. Because of the small surgical field, gait disturbance was resolved within 1 day without other postoperative complications. This technique is potentially useful for harvesting a small amount of iliac PCBM.

Keywords: Bone graft; Minimally invasive surgery; Particulate cancellous bone and marrow; Trephine bur.