Abstract

The purpose of this study was to quantitatively evaluate; 1) mandibular posterior mono-cortical block onlay bone graft success rates 2) the amount of grafted bone retained after initial resorption in radiographic projections. Seven consecutive patients with 14 mandibular posterior implant sites requiring bone augmentation for implants of a standard 3.8mm x 10mm dimension were sought. Mono-cortical block bone grafts from the ipsilateral ascending ramus were placed then observed with two standardized CT scans, dividing them into two groups: Group A had the first CT at 4 weeks after graft placement and a second taken before Prosthodontic reconstruction, 36.7 weeks later. Group B scans were taken at 4.7 weeks post-grafting and prior to stage I implant surgery, and 15.6 weeks later. The same seven CT slices per implant site were measured using a radiographic reference marker in two different patient repositioning devices, one for each group. A two sample t-test and Mann-Whiteney (sic) U test were used for statistical analysis of the percentage bone resorption and radiographic distortion between the two groups. The resulting overall graft survival rate was 80% with an 83.3 and 75% rates for Group A and Group B respectively. The mean graft resorption for both groups was 25.77% with Group A 44.26% and Group B 1.11%. 9 sites had a mean net bone loss of 48.9% while 5 sites had a mean net bone gain of 15.9%. Group A resorption was statistically significantly greater than for Group B (p = 0.028). Mean radiographic distortion was 1.93% with Group A having 1.87% and Group B 2%. No statistically significant difference in distortion percentage between Groups (p = 0.345) was observed. A wide variability in bone resorption in block grafting appeared dependent on: the degree of vascularity and fixation at the host site, maintaining primary closure through-out healing, and how much time has passed since initial graft placement. All sites were adequate for implant placement: 3 sites required smaller and 2 larger implants than planned. All implants survived a mean 17 months observation time. Within the limits of a small sample this study provides information about the variable healing behavior for mandibular bone grafting procedures.

LLU Discipline

Implant Dentistry

Department

Implant Dentistry

School

Graduate School

First Advisor

Joseph Kan

Second Advisor

Jay Kim

Third Advisor

Jaime Lozada

Fourth Advisor

Carl Misch

Fifth Advisor

Carlos Munoz

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

2003

Date (Title Page)

9-2003

Language

English

Library of Congress/MESH Subject Headings

Dental Implantation -- methods; Bone Regeneration; Bone and Bones -- physiology; Reconstructive Surgical Procedures

Type

Thesis

Page Count

ix; 98

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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