Abstract:
Background. The implant-prosthetic rehabilitation in conditions of bone atrophy supposes a
bone augmentation surgery with biomaterials of various origins. The optimal mixture of grafting
material is considered to be a mixture of 50/50% of autogenous and xenogenic bone. Often the
necessary quantity of autogenous graft is difficult or impossible to harvest from intraoral sites.
The iliac crest represents a very important bank of bone tissue for reconstructions, from
quantitative and qualitative points of view. The classic method of iliac crest bone harvesting
consists in making of an extended incision, of 5-7 cm, with its dissection and exposure, in order
to harvest the cortico-cancelous blocks, used in the reconstruction itself or milled. This invasive
method has an increased risk of complications such as pain, gait disturbance, sensitivity
disorders, hernia of abdominal organs, hematoma, iliac crest fracture etc.
Aim of the study. Evaluation of minimally- invasive method of harvesting the cortico-cancelous
graft from iliac crest with using cylindrical device.
Case report. The study was axed on a patient of 34 years old, who suffered an accidental fall
trauma at the age of 22, resulted in avulsion of superior incisors with horizontal and vertical
defect of alveolar bone. To restore the defect, a bone augmentation using GBR technique with
particulated autogenic and xenogenic grafting material has been performed, in relation of
50/50%, 7 cm3 in volume. The autograft, harvested from iliac crest with minimally- invasive
approach, was particulated in bone-mill. For the graft stabilization, a resorbable membrane fixed
with screws was used.
Results. The wound healing in receptor site took place in conventional terms, without
peculiarities, but on the donor site a faster healing and an insignificant scar formation has been
noticed. The clinical and radiological examination (panoramic X-ray, CBCT) at 3 month postoperative
period showed a good bone volume formation, absence of complications both on the
donor and receptor sites. The advantage of the used method comparatively to the classical one
consists in following: the incision line reduction, limited decolation with minimal trauma of soft
tissues; directed bone graft harvesting in the inter-cortical space, that has reduced the traumatic
impact on iliac crest, avoided fracture, hematoma, peritoneum perforation or abdominal organs
hernia. By this way, the morbidity of donor site has been significantly reduced and allowed early
rehabilitation of the patient.
Conclusions. The minimally- invasive method of iliac crest bone harvesting is easy and rapid,
well-accepted by the patient and with good results and reduced morbidity
