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The International Journal of Oral & Maxillofacial Implants
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Int J Oral Maxillofac Implants 17 (2002), No. 2     15. Apr. 2002
Int J Oral Maxillofac Implants 17 (2002), No. 2  (15.04.2002)

Page 238-248


The Use of Ramus Autogenous Block Grafts for Vertical Alveolar Ridge Augmentation and Implant Placement: A Pilot Study
Proussaefs, Periklis T. / Lozada, Jaime L. / Kleinman, Alejandro S. / Rohrer, Michael D.
Purpose: This study presents a clinical, radiographic, laboratory, and histologic/histomorphometric analysis of the use of mandibular ramus block autografts for vertical alveolar ridge augmentation and implant placement.
Materials and Methods: Autogenous block autografts were fixed at the recipient site with fixation screws while a mixture of autogenous bone marrow and inorganic bovine material (Bio-Oss) was used at the periphery. All grafts appeared well incorporated at the recipient site during reentry surgery.
Results: Radiographic measurements revealed an average of 6.12 mm vertical ridge augmentation 1 month after surgery and 5.12 mm 4 to 6 months after surgery. Laboratory volumetric measurements revealed an average of 0.91 mL alveolar ridge augmentation 1 month after surgery and 0.75 mL 6 months postoperatively. Linear laboratory measurements revealed 6.12 mm of vertical ridge augmentation 1 month postoperatively and 4.37 mm 4 to 6 months after surgery. Histologic evaluation indicated signs of active remodeling in all the specimens. Histomorphometric analysis of the peripheral particulate bone indicated bone present at 34.33% of the grafted area, while 42.17% of the area was occupied by fibrous tissue and 23.50% by residual Bio-Oss particles.
Discussion: The results demonstrated the potential of mandibular block autografts harvested from the ascending ramus to maintain their vitality. Volumetric resorption rate of 17.58% and radiographic resorption rate of 16.34% were in accordance with previously published literature. Early exposure appeared to compromise the results, while late exposures did not affect the vitality of the block autografts.
Conclusion: Mandibular block autografts can maintain their vitality when used for vertical alveolar ridge augmentation. Inorganic bovine mineral (Bio-Oss) can be used at the periphery of the block graft when mixed with autogenous bone marrow.

Keywords: block grafts, vertical ridge augmentation