[The proximal tibia. A possible donor site in preprosthetic surgery]

With the development of oral implantology the augmentation of the alveolar process and the maxillary sinus has become a more and more frequent procedure. Even though a vast array of bone replacement materials is available commercially, they all just have an osteoconductive effect. By now it has become clear that the 'gold standard' of bone grafts is autologous bone that is both osteoconductive and osteoinductive. Autologous bone is mostly harvested from intraoral sources. If a larger quantity of spongious bone is needed, it is from extraoral sites, mainly from the iliac crest. In some countries the use of the proximal epiphysis of the tibia for bone harvesting is more widespread. In our Department a sinus lift was performed with spongious bone harvested from the tibia in 14 patients within 9 months. A mean 20 cc of bone can be harvested from one site, which is sufficient for the augmentation of both sinus floors in all cases. The patients tolerated surgery well, healing was without complications. Patients were mobilised immediately after surgery. Patients tolerated the postoperative period significantly better than after bone harvesting from the iliac crest.