The Use of the Mandibular Ramus for Alveolar Reconstruction in Oral Implantology

Bone grafts are widely used in alveolar ridge augmentations to allow correct implant installations. Intraoral donor sites, such as the maxillary tuberosity, symphysis and mandibular ramus have presented good characteristics and outcomes; however, the mandibular ramus has comparative advantages that promote its increased use. The aim of this work is to describe the current results of the mandibular ramus as a donor site for obtaining bone grafts to be used in alveolar bone augmentations in oral implantology and to determine the survival rate of the implants installed in the grafted sites. A systematic search of the scientific literature between December 2000 and March 2017 was carried out on the MEDLINE, EMBASE, LILACS and SciELO databases, analyzing each article according to the method of diagnosis and planning, bone resorption at the receptor site, presence of postoperative complications and implant survival rate. Eleven works were included in this study with an average of 43 patients; the follow-up times varied between 6 and 120 months, considering in addition an average success rate of 98.7 % in the implants installed in sites reconstructed with mandibular ramus bone; low morbidity in the site mainly linked to temporary neurosensory alterations was identified. It may be concluded that the need for a second surgical site to obtain graft material and the longer time the treatment requires until implant rehabilitation continue to be disadvantages; nevertheless, the mandibular ramus donor site presents low morbidity, high versatility in its use and predictable results for the dental implant installation.

[1]  Z. Haidar,et al.  The Use of the Mandibular Ramus for Alveolar Reconstruction in Oral Implantology , 2017 .

[2]  T. Reiner,et al.  Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial , 2017, Clinical implant dentistry and related research.

[3]  P. Fletcher,et al.  Fresh-Frozen Bone Allografts in Maxillary Alveolar Augmentation: Analysis of Complications, Adverse Outcomes, and Implant Survival. , 2016, Journal of periodontology.

[4]  Alexander Schramm,et al.  Clinical results of autologous bone augmentation harvested from the mandibular ramus prior to implant placement. An analysis of 104 cases , 2016, GMS Interdisciplinary plastic and reconstructive surgery DGPW.

[5]  S. Olate,et al.  Bone Formation in Maxillary Sinus Lift Using Autogenous Bone Graft at 2 and 6 Months. , 2016, International journal of morphology = Revista internacional de morfologia.

[6]  S. Olate,et al.  Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm , 2016, Plastic and reconstructive surgery. Global open.

[7]  J. Raguse,et al.  Retrospective long-term analysis of bone level changes after horizontal alveolar crest reconstruction with autologous bone grafts harvested from the posterior region of the mandible , 2016, Journal of periodontal & implant science.

[8]  Juan López-Quiles,et al.  Complications in the use of the mandibular body, ramus and symphysis as donor sites in bone graft surgery. A systematic review , 2016, Medicina oral, patologia oral y cirugia bucal.

[9]  A. Khojasteh,et al.  Success rate of implants placed in autogenous bone blocks versus allogenic bone blocks: A systematic literature review , 2016, Annals of maxillofacial surgery.

[10]  Andrezza Lauria,et al.  8-10 year follow-up survival of dental implants in maxillae with or without autogenous bone graft reconstruction. , 2015, International journal of clinical and experimental medicine.

[11]  Yong-Deok Kim,et al.  Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis , 2015, Journal of the Korean Association of Oral and Maxillofacial Surgeons.

[12]  P. Infante-Cossio,et al.  Calvarial Bone Grafting for Three-Dimensional Reconstruction of Severe Maxillary Defects: A Case Series. , 2015, The International journal of oral & maxillofacial implants.

[13]  M. Chiapasco,et al.  Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. , 2015, The International journal of oral & maxillofacial implants.

[14]  D. Dolanmaz,et al.  The use of autogeneous mandibular bone block grafts for reconstruction of alveolar defects , 2015, Annals of maxillofacial surgery.

[15]  H. Schaaf,et al.  Horizontal alveolar ridge augmentation using autologous press fit bone cylinders and micro-lag-screw fixation: technical note and initial experience. , 2014, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[16]  M. Peñarrocha-Diago,et al.  Implant treatment in atrophic posterior mandibles: vertical regeneration with block bone grafts versus implants with 5.5-mm intrabony length. , 2014, The International journal of oral & maxillofacial implants.

[17]  M. Claudino,et al.  Tomographic follow-up of bone regeneration after bone block harvesting from the mandibular ramus. , 2014, International journal of oral and maxillofacial surgery.

[18]  Emeka Nkenke,et al.  Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. , 2014, European journal of oral implantology.

[19]  R. Mazzonetto,et al.  Selección de osteosíntesis en la reconstrucción maxilar con injerto óseo de cresta iliaca , 2013 .

[20]  M. SergioOlate,et al.  Osteotomías craneomaxilofaciales con sistemas ultrasónicos , 2013 .

[21]  Leandro Klüppel,et al.  Histometric analyses of cancellous and cortical interface in autogenous bone grafting. , 2013, International journal of clinical and experimental pathology.

[22]  T. Chaturvedi,et al.  Reconstruction of localized maxillary ridge defect with autogenous mandibular ramus block bone graft for dental implant placement , 2013 .

[23]  F. Haiter-Neto,et al.  Morphometric Study of Mandibular Ramus Related to Sagittal Ramus Split Osteotomy and Osteosynthesis , 2012, The Journal of craniofacial surgery.

[24]  Luca Cordaro,et al.  Mandibular bone harvesting for alveolar reconstruction and implant placement: subjective and objective cross-sectional evaluation of donor and recipient site up to 4 years. , 2011, Clinical oral implants research.

[25]  T. M. Duque,et al.  Prospective Clinical Assessment of Morbidity After Chin Bone Harvest , 2011, The Journal of craniofacial surgery.

[26]  L. Ottria,et al.  Success rate of dental implants inserted in autologous bone graft regenerated areas: a systematic review. , 2011, ORAL & implantology.

[27]  S. Olate,et al.  Consideraciones clínicas en la obtención de injertos óseos intraorales: Técnica quirúrgica y evaluación de las complicaciones , 2010 .

[28]  G. Meijer,et al.  The potential of the horizontal ramus of the mandible as a donor site for block and particular grafts in pre-implant surgery. , 2009, International journal of oral and maxillofacial surgery.

[29]  A. Happe Use of a piezoelectric surgical device to harvest bone grafts from the mandibular ramus: report of 40 cases. , 2007, The International journal of periodontics & restorative dentistry.

[30]  P. Proussaefs,et al.  The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: a pilot study. , 2002, The International journal of oral & maxillofacial implants.