Tuberosity-alveolar block as a donor site for localised augmentation of the maxilla: a retrospective clinical study
Khojasteh A, Nazeman P, Tolstunov L
Bone from the maxillary tuberosity has been harvested in particulate form to use for augmentation for several years, but block grafts have not been extensively used. A considerable advantage of a particulate bone graft from the maxillary tuberosity over those from other intraoral donor sites is the relative simplicity of harvesting and minimal complications. We have retrospectively assessed the efficacy of tuberosity-alveolar block bone (posterior maxillary alveolar ridge) in the augmentation of adjacent defects in the maxilla using data from 14 patients (10 men and four women, mean (range) age 55 (38-69) years) who had had 20 bony augmentations with block bone from the alveolar tuberosity during 2014. Patients were divided into three groups according to the technique by which the bone was collected. The first group had a graft from the alveolar tuberosity covered with titanium mesh (titanium mesh group); the second group had the block bone covered by platelet rich fibrin and collagen membrane (platelet rich fibrin group), and in the third group the graft was covered only with periosteum (periosteum group). The primary width of the bone was recorded at the time of placement of the graft and changes were evaluated 4-6 months later when the implant was inserted. The changes in the width of the bone were 4.1, 3.3, and 2.5 in the platelet rich fibrin, titanium mesh, and periosteum groups, respectively. The difference in bony change among groups was not significant except between the platelet rich fibrin and and periosteum groups (p=0.005). Tuberosity-alveolar block bone graft may be a good source of bone for augmentation of deficient ridges, and more favourable results can be expected by the addition of resorbable membranes and growth factors.