Irradiated human bone for block graft on narrow ridge: thoughts?
I would be interested in readers views on the use of irradiated human bone from a bone bank as an onlay block graft to augment a narrow ridge in the upper incisor region prior to implant installation. The ridge has an acceptable height but is too thin buccopalatally for conventional implant installation without a significant chance of failure. The plan is to onlay two bone blocks, fix them with screws and cover with a resorbable membrane. Is it likely that irradiated bone will create a suitable site for implant installation? I only have experience of placing autologous grafts in such situations. Thanks for any feedback.
3 Comments on Irradiated human bone for block graft on narrow ridge: thoughts?
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ahmed sharkawy
2/11/2014
i used onlay blocks from rocky mountain tissue bank in restoring upper anterior narrow ridges for implant placement and covered with collagen membranes, they showed good results in comparison with autogenous blocks, repid resorption but the remaining is enough for implant placement
Gerald Rudick
2/11/2014
What you are describing is a proven technique for widening an edentulous ridge, using bone blocks obtained from a legitimate tissue bank.
Bear in mind that before attempting to screw on the blocks, you must decorticate the recipient site, drill a series of small holes into it to promote angiogenesis, and relieve your mucoperiosteal flap so that you will be able to stretch and approximate the soft tissues together when suturing.
It is a good idea to use L-PRF from centrifuging the patient's blood, compressing the clots to form fibrin membranes and the exudate obtained from the pressing process, can be used as a wetting agent for the particulate biomaterials you will use as a filling agent around the blocks.
It is important to have a tension free closure, and to check the patient's cholesterol level to make sure he/she is healthy enough for the procedure.
In the Sept/October 2013 issue of Implant News & Views I published an article on using PRF and how you can use this technique inexpensively by obtaining a sterilizable excellent quality garlic press from Ikea to press the Fibrin clots....good luck, and leave it in place for at least six months before attempting implants.
Dr. Gerald Rudick AF AAID; F,D,P ICOI
gary OMFS
2/12/2014
Is it a cortical/ cancelous or corticocancellous graft? I'm also very interested in this technique. Inevitably healing time will be longer, but how much? Especially in cortical grafts.