A radiographic analysis of anatomical variation at the mandibular sites of intraoral bone harvesting

• Published in: Oral surgery Vol. 11; no. 2; pp. 105 - 111
• Main Authors: Adams, RJ, Hamid, L., Binney, A., Claydon, N., Farnell, D., Griffiths, B., Thomas, DW
• Format: Journal Article
• Language: English
• Published: Edinburgh Wiley Subscription Services, Inc 01-05-2018
• Subjects: Bone grafts; Canine teeth; CBCT; Dental implants; Dental roots; donor site; grafting; implant bone; Mandible; Nerves; Patients; Surgery
• ISSN: 1752-2471; 1752-248X
• DOI: 10.1111/ors.12304

Objectives
Intraoral bone grafting is an important component of implant treatment, but also a source of intra‐ and post‐operative complications. This study sought to determine the relationship of bone surface to underlying nerves and vasculature, at the two most commonly employed intraoral sites for bone harvesting.
Materials and Methods
Data were collected by direct measurement of 103 potential graft sites (50 retromolar sites: 53 symphyseal sites) of patients undergoing CT scanning for implant surgery assessment.
Results
Symphyseal analysis included 26 female and 27 male patients. Data recorded were as follows: maximal width of the mandible between lower central incisor root tips (mean: 13.7 mm; range: 11.3–16.4 mm), maximal width of the mandible below the canine tip (mean: 11.5 mm; range: 7.7–14.9 mm), tip of canine to mandibular incisive nerve (mean: 4.3 mm; range: 1.2–8.9 mm), canine root tip to outer labial cortex (mean: 4.0 mm; range: 1.9–7.3 mm) and midline distance from the incisive nerve to outer labial cortex (mean: 3.0 mm; range: 1.0–6.9 mm). Retromolar analysis comprised of 33 female and 17 male patients. Data recorded included distance from inferior dental canal to the outer buccal cortex (mean: 3.2 mm; range: 1.0–7.9 mm), the most buccal point of the lower second molar roots to the outer buccal cortex (mean: 3.3 mm; range: 1.0–6.5 mm) and thickness of the mandibular crest at the lower second molar (mean: 13.8; range: 10.2–18.2 mm).
Conclusions
The proximity of underlying vital structures may be easily overlooked in routine examination of implant patients and may be related to patient characteristics.