Assessment of bone quality using buccal and palatal autogenous cortical shells harvested from two different mandibular d
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ORIGINAL ARTICLE
Assessment of bone quality using buccal and palatal autogenous cortical shells harvested from two different mandibular donor sites for maxillary alveolar ridge augmentation: a histomorphometric randomized clinical trial Mohamed Mounir 1 & Ola Alaa EL Morsy 2 & Hatem Amer 3 & Samy Mounir 4 & Amr Gibaly 5 Received: 25 August 2020 / Accepted: 9 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose This study aims to compare the quality of free autogenous bone grafts harvested from two different mandibular donor sites, used as onlay shells to augment horizontally and vertically deficient anterior maxillary alveolar ridges. Methods Fourteen patients with edentulous and atrophic anterior maxillae are randomly allocated into two groups. Seven symphyseal chin (group I) and seven retromolar (group II) mandibular bone grafts were harvested and fashioned to construct buccal and palatal frameworks, fixed in place with mini-screws, followed by compacting the inter-positional gaps with an equal particulate mix of xenograft and autogenous cancellous particulates. Six months later, 42 core biopsies, three from each patient, 21 for each study group, were retrieved before the implants’ insertion and subjected to histomorphometric bone area percent analysis. Results The bone area percent of the newly formed bone augmented with the chin shells was 52.53 ± 1.68% versus 47.97 ± 1.83% for the retromolar grafts. The mean area percent difference between both groups was statistically significant (p = 0.0004). Conclusion A higher bone quality and more volumetric stability were associated with the symphyseal cortical shells. Clinical trial registration The study was registered on www.clinicaltrials.gov (#: NCT03607006) in July 2018 by Ola Alaa El Morsy. Keywords Autogenous bone graft . Onlay cortical shells . Bone histomorphometry
Introduction Bones are systemized, dynamic, and changeable tissues composed of cells, minerals, and organic matrix that
* Amr Gibaly [email protected]; [email protected] 1
Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
2
Oral and Maxillofacial Surgery, Faculty of Dentistry, Future University in Egypt, Cairo, Egypt
3
Oral and Maxillofacial Pathology, Faculty of Dentistry, Cairo University, Cairo, Egypt
4
Oral and Maxillofacial Surgery, Faculty of Dentistry, October University for Modern Sciences and Arts, Sixth of October City, Egypt
5
Oral and Maxillofacial Surgery, Faculty of Dentistry, Beni-Suef University, East Nile educational compound, Beni-Suef 62764, Egypt
adapt to various metabolic and mechanical coincidences. The post-extraction alveolar bone resorption frequently demands bone grafting to accommodate a firm housing of dental implants, with adequate bone volume with condensed consistency. [1] Cortico-cancellous autogenous bone grafting remains the gold standard. Although the cortical portion constitutes rigid scaffolds that provide the mechanical stability required for healing and preser
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