Extensive augmentation of the alveolar ridge using autogenous calvarial split bone grafts for dental rehabilitation

Free autogenous iliac bone is the most commonly used graft material for an extensive alveolar ridge reconstruction. The application of iliac bone, however, is associated with problems, such as transplant loss resulting from postoperative infection and late bone resorption. A bone-graft material more suitable than iliac bone is therefore still needed. This paper describes a concept for alveolar-ridge reconstruction using calvarial split bone, and the related surgical techniques. Clinical and radiological follow-up examinations were undertaken to evaluate the potential benefit of calvarial split bone in alveolar-ridge reconstruction. Between 1999 and 2002, 13 patients with a mean age of 54 years (range 31-70 years) underwent surgery, seven patients in the maxilla and six in the mandible. In four cases, wound dehiscence occurred postoperatively. In one of these cases, the dehiscence was associated with a local infection. However, no bone transplants were lost. After a mean follow-up time of 19.6 months, bone resorption, measured radiologically, was minimal. Endosseous dental implants were successfully installed and maintained. Satisfactory prosthetic rehabilitation was achieved in all patients. Our preliminary experience suggests that calvarial split bone may be regarded as a promising alternative to autogenous iliac bone in connection with extensive augmentation of the alveolar ridge.