Santhanakrishnan Muthukumar, Rangarao Suresh
Department of Periodontics, Sri Ramachandra Dental College, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India.
J Indian Soc Periodontol. 2014 Nov-Dec;18(6):767-71. doi: 10.4103/0972-124X.147423.
Restoration of lost alveolar bone support remains as one of the main objectives of periodontal surgery. Amongst the various types of bone grafts available for grafting procedures, autogenous bone grafts are considered to be the gold standard in alveolar defect reconstruction. Although there are various sources for autogenous grafts including the mandibular symphysis and ramus, they are almost invariably not contiguous with the area to be augmented. An alternative mandibular donor site that is continuous with the recipient area and would eliminate the need for an extra surgical site is the tori/exostoses. Bone grafting was planned for this patient as there were angular bone loss present between 35-36 and 36-37. As the volume of bone required was less and bilateral tori were present on the lingual side above the mylohyoid line, the tori was removed and used as a source of autogenous bone graft, which were unnecessary bony extensions present on the mandible and continuous with the recipient area. Post-operative radiographs taken at 6 and 12 month intervals showed good bone fill and also areas of previous pockets, which did not probe after treatment indicates the success of the treatment. The use of mandibular tori as a source of autogenous bone graft should be considered whenever a patient requires bone grafting procedure to be done and presents with a tori.
恢复缺失的牙槽骨支持仍然是牙周手术的主要目标之一。在可用于移植手术的各种类型的骨移植材料中，自体骨移植被认为是牙槽骨缺损重建的金标准。尽管自体移植有多种来源，包括下颌骨联合和下颌支，但它们几乎总是与需要增大的区域不相邻。与受区连续且无需额外手术部位的下颌骨替代供区是隆突/外生骨疣。由于该患者在35 - 36和36 - 37之间存在角形骨吸收，因此计划进行骨移植。由于所需骨量较少，且在舌骨肌线以上的舌侧存在双侧隆突，于是将隆突切除并用作自体骨移植的来源，隆突是下颌骨上存在的与受区连续的不必要的骨质延伸。术后每隔6个月和12个月拍摄的X光片显示骨填充良好，并且先前存在牙周袋的区域在治疗后探诊不到，这表明治疗成功。每当患者需要进行骨移植手术且存在隆突时，应考虑使用下颌隆突作为自体骨移植的来源。
