Use of fresh frozen bone graft in rehabilitation of maxillar atrophy

Fresh frozen bone (FFB) is homologous bone obtained from human donors, provided by Tissue Banks. It is a graft material in reconstructive surgery; it is currently and widely used in orthopedic surgery and lately it has been introduced in oral and maxillofacial surgery. The purpose of this work was to show the use of fresh frozen homologous bone for bony augmentation of the maxilla and mandible in preparation for dental reconstruction with endosseous implants, as an effective alternative to harvesting and grafting autogenous bone from intra- or extra-oral donor sites.

The case presented clinically demonstrates the use of FFB grafts in the vertical augmentation of a severe maxillary atrophy in general anesthesia, and the outpatient treatment with implants insertion and prosthetic restoration. Histologic evaluation of graft biopsy six months after surgery is added to clinical assessments.

Clinical outcome is shown with good volumetric and morphological reconstruction of the alveolar ridge without the need of a donor site. Excellent graft integration and bleeding newly formed bone was seen at the second surgical step (six months after FFB grafting), when fixation screws were removed and implant placement procedure was performed.

The use of FFB in major preprosthetic surgery may be an acceptable therapeutic alternative to the autogenous block graft (harvested from iliac crest or calvarium) for its success rate as graft material. Benefits include: surgical procedure with reduced discomfort and infection risk as a second operation field to harvest the graft is avoided; FFB is safe, cheap and available in programmed amounts, its use can significantly reduce operating time.