[The use of autogenous block graft for augmentation of the atrophic alveolar ridge]

The use of osseointegrated implants has become a standard treatment option in modern dental rehabilitation. Adequate bone quantity and quality is a prerequisite for good esthetic and biomechanical result. Alveolar ridge defects can be the result of trauma, periodontal diseases or other pathologic conditions. In these cases, alveolar ridge augmentation is needed if endosseous implants are to be used. While xenografts, alloplastic bone grafts and allografts have been proposed for alveolar ridge augmentation, the use of autogenous bone grafts represents the "gold standard" for bone augmentation procedures. Either intraoral or extraoral sites may be considered for donor sites. Although the iliac crest is the most common donor site in maxillofacial reconstruction, the mandibular symphysis or ramus offer important advantages like avoidance of general anesthesia, convenience due to the proximity between the donor site and the augmentation site and avoidance of cutaneous scar. Bone harvested from intraoral donor site is less associated with resorption when compared with iliac bone because membranous grafts revascularize more quickly than endocondral bone grafts. The main disadvantage of the intraoral donor sites is the limited amount of available bone. Alveolar ridge augmentation using autologous bone block, can be done during implant placement or staged with implant placement, after bone graft healing. In the staged technique, a better implant positioning and the use of wide diameter implants are possible. The overall implant success is higher in the staged technique. Alveolar ridge augmentation using autogenous block graft is a predictable way of treatment, for the atrophic alveolar ridge before implant placement.