Harvesting Mandibular Ramus Bone Grafts Using Ultrasonic Surgical Device: Report of 20 Cases

Successful osseointegration of the dental implants requires sufficient bone volume surrounding implant site. The mandibular ramus is considered reliable donor site for reconstructing alveolar ridge defects prior to dental implant placement. The aim of this study was to present the clinical efficiency of using ultrasound surgery for harvesting mandibular ramus bone graft. 20 patients (10 male, 10 female; mean age 47.5 ± 11.4years) with insufficient bone volume, who underwent autogenous bone grafting prior to implant placement, were presented. The grafts were harvested from the ascending ramus along with the external oblique ridge using an ultrasound surgical device (Piezosurgery, Mectron, Italy) from 20 donor sites and used to augment alveolar ridge atrophies. After waiting 4 to 5 months for healing grafted sites, 48 dental implants were inserted. Clinical parameters such as inferior alveolar nerve (IAN) damage, complications at donor and recipient site, the size of the graft and implant placement at the proper site were evaluated retrospectively. Mean graft length was 20.1mm (SD=2.73), and mean graft width was 12mm (SD=2.47). Of 20 recipient sites, 20 healed uneventfully, and of 20 donor sites 18 healed uneventfully. Only one patient had transient altered sensitivity of the lower lip. Ultrasound surgery allowed precise and smooth bone cutting with better intraoperative visibility. Specially angulated tip of the devise made inferior horizontal cut easier and safer. The results of this study suggest that the use of ultrasound surgery is an effective method for harvesting bone grafts from mandibular ramus with avoidance of any major complication.