Development of hard tissues with block grafting techniques

Abstract

Adequate bone and soft tissue volume is necessary for long-term functional and aesthetic success of dental implants. This article discussed how much bone is needed for implant success as well as how to diagnose bone volume with the use of cone beam computed tomography. Options such as ridge split, guided bone regeneration with titanium membranes, and titanium mesh are discussed, but the focus of this chapter is block grafts. A decision tree is given for choosing a donor site for block grafts considering anatomic factors and patient comfort-related factors. For block grafts in the anterior mandible, the mandibular symphysis is the donor site of choice. The posterior mandible lends itself to harvest bone from the external oblique ridge or ramus. For the premaxilla, block allografts are the donor bone of choice. This chapter is dedicated to block allografts in the aesthetic zone of the premaxilla. The technique of incision design; recipient site preparation; releasing buccal flaps; placing fixation screws; shaping the block, particulate bone, and membranes; and suturing is covered. Complications of block grafting are briefly covered.