Computerized Tomographic Evaluation of Symphyseal Donor Sites Used in the Reconstruction of the Posterior Maxilla: A Case Report of 2 Patients
Autogenous bone grafts are commonly used for reconstruction of the deficient maxillary alveolar ridge. Mandibular ramus, symphysis, extraction sites, and retromolar sites are the most common sources for harvesting autogenous bone grafts from intraoral regions. Several authors have used computerized tomography (CT) to evaluate the dimensional change of bone graft, but there are limited reports evaluating donor sites for autogenous bone. In this report, 2 patients were treated with autogenous bone graft from the mandibular symphysis. Postoperative CT scans were used to evaluate the radiographic change in the symphyseal area. The patients treated with autogenous bone showed uneventful healing at the donor and recipient sites and good acceptance of the procedure. At the final evaluation, CT analysis demonstrated a persisting radiolucency in the donor area, even though the defect size was reduced. Further evaluation may be needed to evaluate the progress of remineralization and long-term results.Abstract

(a) Clinical photograph taken at the initial visit. (b) Preoperative panoramic view of computerized tomography scan. (c) Preoperative cross-sectional view of the symphysis. (d) Preoperative cross-sectional view of the maxillary right molar area.

Figure 2 . (a) The bone graft is harvested from the symphysis area of the mandible. (b) The buccal view of the donor site after the layered suture. (c) Bone graft 15-mm wide by 5-mm high. Figure 3. One-month postoperative buccal view of the donor site.

Figure 4 . (a) A 5.5-month postoperative axial view of computerized tomography (CT) scan showing good adaptation of the block bone. (b) A 5.5-month postoperative panoramic view of CT scan. (c) A 5.5-month postoperative cross-sectional view of CT scan. Figure 5. (a) A 6-month postoperative occlusal view showing increased width of the alveolar ridge. (b) Clinical view showing that the bone block is integrated with the recipient alveolar bone. (c) Buccal view after sinus augmentation procedure.

Figure 6. Radiograph taken at the initial visit. Figure 7. Panoramic radiograph taken after the sinus augmentation procedure. Figure 8. A 9-month postoperative buccal view of the donor site.

Figure 9 . (a) One-year postoperative panoramic view of computerized tomography (CT) scan of the upper right molar area. (b) One-year postoperative cross-sectional view of CT scan. Figure 10. Clinical view of the prosthesis in function at the final evaluation.
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