Maxillary sinus and ridge augmentations using a surface-derived autogenous bone graft

Purpose: The purpose of this article is to describe a new technique and the anatomic sites for cutting and harvesting bone for grafting applications. A handheld instrument is described that cuts and collects thin shavings of bone from cortical surfaces. Materials and Methods: This study included 193 consecutive patients who needed bone augmentation and simultaneous implant placement in the severely atrophic posterier maxilla and in the anterior maxilla with acquired defect of alveolar bone as a result of local trauma. A total of 477 implants were placed. Clinical criteria for evaluation at time of implant exposure included stability in all directions, crestal bone resorption, and any reported pain of discomfort. Results: There were no failures of the anterior maxilla group, and no signs of bone resorption were noted at the second stage surgery or during the follow-up. During initial and late healing, there was no dehiscence of the soft tissue flaps and no membranes were exposed. Core biopsies typically showed immature, newly formed bone and, on average, 27% to 36% vital bone. Conclusion: From this research, it appears that excellent implant success rates can be achieved in grafted sinuses or ridges when a locally harvested autogenous bone graft with a ribbon geometry is used. (C) 2004 American Association of Oral and Maxillofacial Surgeons