Alveolar bone reconstruction with autogenous intraoral grafts in the context of posttraumatic rehabilitation

Abstract

Background. The rehabilitation in conditions of bone loss supposes a bone augmentation surgery. The optimal choice for this kind of performance is the autogenous grafts harvested from the patients own body especially intraoral sites. Khoury introduced a new method for grafting ridge defects in 2007, using thin cortical plates harvested from the ramus, and in a 'sandwich' type manner, interposed these bone plates with cancellous bone harvested from the same site. The principles involved in successful bone grafts include osteoconduction, osteoinduction, and osteogenesis. Osteogenesis only occurs with autograft tissue and cellular bone matrices therefore. Case report. 21-year-old female presented for the restoration of her missing dentition in her upper jaw due to an early childhood trauma. CBCT revealed a large horizontal and vertical bony deficiency in the region of the upper anterior teeth, The Khoury technique was decided to aply, using bone fixation screws, the bone plates that were harvested from the ramus were fixed to the buccal defect, the space between the plate and the existing palatal bone wall was then filled using a combination of autograft bone scrapings and xenograft bone particles. Six months after the initial surgery, the grafted sites were surgically re-entered and showed a marked increase in ridge dimensions from 4,2 to 9,5 mm. The regeneration of the alveolar crests took place in conventional terms without complications, donor site was fully restored without signs of morbidity. The radiological and clinical examinations 6 moths postoperative showed up a good result of bone formation nearly 5.3 mm. The advantages of using mostly intraoral autografts in GBR tehnique comparatively to others is that they provide a good bone regeneration, stimulate local resources of the bone, serve as the source of BMP, serves as a scaffold for new bone growth that is perpetuated by the native bone, actually autografts integrate all basic peculiarities that the bone needs to regenerate its structure and reestablish all the physiological functions. Conclusions. The usage of autogenous intraoral grafts as a method of augmentation appeared to give a stable and relatively quick result. If good surgical skills are performed, the graft seems to facilitate tissue healing and promote bone formation that is most important for the subsequent posttraumatic rehabilitation of the patient.