Evaluation of bone availability for grafts in different donor sites, through computed tomography

J Appl Oral Sci. 2020 Feb 7:28:e20190435. doi: 10.1590/1678-7757-2019-0435. eCollection 2020.

Abstract

Objective: To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap.

Methodology: For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered.

Results: The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained.

Conclusions: Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anatomic Landmarks
  • Bone Transplantation / methods*
  • Cone-Beam Computed Tomography / methods*
  • Cortical Bone / diagnostic imaging
  • Cortical Bone / transplantation
  • Female
  • Humans
  • Male
  • Mandible / diagnostic imaging
  • Mandible / transplantation*
  • Medical Illustration
  • Middle Aged
  • Retrospective Studies
  • Skull / diagnostic imaging
  • Skull / transplantation*
  • Transplant Donor Site* / diagnostic imaging
  • Young Adult