Evaluation of symphysis donor site quantity by cone-beam computed tomography and its relation to anterior loop of...

For severely atrophic alveolar ridges, block grafting procedures are usually decided to use for reliable results. Various intraoral donor sites for autogenous block graft are presented in the literature. However, vital anatomic structures can limit intraoral bone block graft surgeries, and they must be evaluated in detail. The aim of this study is to evaluate the dimensions and volume of the maximum potential symphysis block graft donor site and their relations to the anterior loop of mental foramen.

According to inclusion criteria, 408 cone beam computed tomography (CBCT) images were evaluated. Mental foramen diameter, anterior loop length, the maximum potential symphysis graft dimensions (height, width, and length) and volume were measured.

Prevalence of anterior loop of mental foramen was calculated 30.15% (123 patients) for right and 29.66% (121 patients) for left sides. The length of anterior loop of mental foramen was measured for right and left side 4.470 ± 1.355 and 5.223 ± 1.599, respectively. The maximum potential symphysis graft height, width, length, and volume were 13.253 ± 3.261 mm, 12.694 ± 1.711 mm, 34.353 ± 2.944 mm, and 3.102 ± 1.013 cm 3, respectively. Presenting anterior loop has no significant effect on the maximum potential symphysis graft height (P = 0.560) and width (P = 0.242). However, the maximum potential symphysis block graft length (P = 0.017) and volume (P = 0.026) were decreased by increasing number of anterior loops of mental foramen.

The mandibular symphysis bone block graft can be reliably selected as the donor site for a number of different augmentation procedures. However, there are restrictions owing to surrounding anatomical structures such as mental foramen and anterior loop. These vital structures should be considered using accurate CBCT evaluation. Presenting anterior loop of mental foramen is limiting symphysis bone block graft length and volume.