Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Cirurgia, Estomatologia, Patologia e Radiologia, Bauru, São Paulo, Brasil.
J Appl Oral Sci. 2020 Feb 7;28:e20190435. doi: 10.1590/1678-7757-2019-0435. eCollection 2020.
To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap.
For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered.
The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained.
Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.
定量分析 3 个供体部位(1)下颌联合部、(2)下颌斜线和(3)颅骨的安全可提取骨量。
对于下颌联合部,通过颏孔前环的延伸、神经、孔之间的距离、颊侧皮质骨与舌侧骨板之间的距离以及上下前牙和下颌骨基底之间的距离,使用 I-CAT Vision 的“距离”工具,对 200 例 CT 检查进行评估。对于下颌斜线,回顾性分析 70 例 TCFC 检查的全景和矢状重建图像,评估颊侧皮质骨的厚度和皮质骨与下颌管之间的距离。对于颅骨,考虑在顶骨区域的一个六边形供体部位。
下颌联合部安全去除的骨块的平均尺寸为:长度 32.27mm,高度 4.87mm,厚度 4mm,提供 628.61mm³的可移植骨量。在斜线部位,可用于移植的骨量为 859.61mm³。在颅骨穹窿区,通过平均骨厚度乘以六边形的面积,获得平均体积为 2499mm³。
比较供体部位,颅骨的可用骨量是下颌后区的 3 倍,至少是下颌联合部的 2 倍。