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. 2022 Nov-Dec;12(6):853-858.
doi: 10.1016/j.jobcr.2022.09.010. Epub 2022 Sep 26.

Reconstruction of osseous defect with symphysis block graft for implant placement

John Roshan  1 , L K Surej Kumar  2 , Sherin N Rahim  3 , G A Adersh  2 , Mathew Joseph Thuruthel  2 , Ahammed Haris H  4
Affiliations

Reconstruction of osseous defect with symphysis block graft for implant placement

John Roshan et al. J Oral Biol Craniofac Res. 2022 Nov-Dec.

Abstract

Introduction: Symphysis being an autogenous bone graft serves as one of the best graft for augmenting osseous defects of alveolar process with excellent results. It has been favoured mainly due to its local availability, accessibility and lesser resorption compared to other bones in the region.

Case report: A 21/M reported to the department of Implantology with the complaint of missing tooth in the upper front tooth region since 1 year. History revealed extraction of upper left central incisor an year ago following trauma. Diagnosis was made as Siebert's Class I with horizontal bone loss irt 21 region with a bone defect of 10.54 x 5.08 x 4.85 mm. So a complete prosthetic rehabilitation protocol was made with an implant placement and grafting was planned with symphysis being most favourable.

Conclusion: The mandibular symphysis is a reliable intraoral graft site that can be used in the office setting with low morbidity. Because of the intraoral approach and lack of cutaneous scarring, patient acceptance is high.

Keywords: Autogenous graft; Implant grafting; Symphysis graft.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Pre-operative photo.
Fig. 2
Fig. 2
CBCT cut showing bone deficiency in 21 region.
Fig. 3
Fig. 3
Axial cut showing bone width of 3.13 mm.
Fig. 4
Fig. 4
3D Reconstructed view showing donor site and recipient site graft measurements.
Fig. 5
Fig. 5
Graft harvesting from symphysis using piezoelectric device.
Fig. 6
Fig. 6
Graft placed at recipient site with 2 self-tapping titanium screws and osseograft placed around the graft.
Fig. 7
Fig. 7
Absorbable collagen membrane held in place using bone tacks.
Fig. 8
Fig. 8
3-0 black silk suture used to close the recipient site.
Fig. 9
Fig. 9
Bone graft fixation with screws seen. Patchy to coarse bony trabecular pattern of D2-D3 type of bone noted.
Fig. 10
Fig. 10
Graft completely taken up by recipient site leaving the titanium screws behind.
Fig. 11
Fig. 11
Placement of Dentium implant 4.3 × 13mm at 21 region.
Fig. 12
Fig. 12
Cement retained prosthesis delivered irt 21.
Fig. 13
Fig. 13
Final cementation of zirconia crown using dual cure resin cement irt 22 and direct composite restoration on 11.
Fig. 14
Fig. 14
Before and after final prosthetic rehabilitation.
See this image and copyright information in PMC

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