Journal of Oral Implantology February 2013 - (Page 103)

CASE REPORT Fracture of Anterior Iliac Crest Following Bone Graft Harvest in an Anorexic Patient: Case Report and Review of the Literature Ugo Covani, MD, DDS1 Massimiliano Ricci, DDS1* Stefano Santini, MD, DDS1 Francesco Mangano, DDS2 Antonio Barone, DDS, PhD, MSc1 In the treatment of jaw bone atrophies, autologus bone is still considered the gold standard because of its excellent osteoconductive, osteoinductive, and osteogenetic proprieties and lack of immunogenicity, which allow better graft integration and stability. Although various donor sites are available, the iliac crest represents the best source of corticocancellous bone, and literature suggests that it has low morbidity. However, this case report emphasizes that patients with systemic diseases such as anorexia should be carefully evaluated before such an operation, because unfavorable bone conditions may jeopardize the outcome. A 47-year-old woman needing rehabilitation of the upper arch was considered for iliac crest harvesting. She stated that she had suffered from anorexia for 30 years. A corticocancellous block was harvested by a bone saw using an anterolateral approach to the outer table of the right anterior iliac crest. The postoperative course was uneventful, but 13 days later, she complained of a sudden pain in the operated area, and X rays revealed a fracture of the anterior iliac crest. So far, the literature has mentioned 50 cases of iliac crest fractures after bone harvesting, and 28 cases among these are due to harvesting in the anterior part of the iliac crest. Several factors seem to be responsible for this complication, including the area of harvesting, residual bone thickness, technique used, and age and gender of the patient. To our knowledge, our case is the first of hip fracture after bone harvesting in a patient suffering from anorexia. Both low weight and osteoporosis are probably responsible for this complication. In our opinion, patients suffering from anorexia should be considered at risk for bone harvesting, and an appropriate mini-invasive surgical technique should be carried out instead. Key Words: iliac crest harvesting, anorexia, fracture INTRODUCTION A 1 lthough a large number of studies have underlined that allogenic, xenogenic, or synthetic materials have important clinical applications in the treatment of jaw bone loss, nowadays Istituto Stomatologico Tirreno, Versilia General Hospital, Lido di Camaiore (Lu), Italy Private pratice, Gravedona (CO), Italy * Corresponding author, e-mail: ricci.massimiliano@yahoo.it DOI: 10.1563/AAID-JOI-D-10-00153 2 autologous bone still represents the gold standard for its excellent osteogenetic characteristics.1,2 Indeed, autologous bone has great osteoconductive, osteoinductive, and osteogenic properties and lack of immunogenicity, which guarantee better integration, stability, and vital bone support for implantology.1,2 When choosing a donor source of nonvascularized bone, the surgeon should take into account the characteristics and size of the defect.3 If the amount of bone needed is limited, intraoral sites will be suitable, but if larger amounts Journal of Oral Implantology 103

Table of Contents for the Digital Edition of Journal of Oral Implantology February 2013

Could the Fountain of Youth Be All in Your Bones?
Vertical Bone Augmentation With Simultaneous Implant Placement Using Particulate
Evaluation of the Bone Healing Process Utilizing Platelet-Rich Plasma Activated by Thrombin
Effect of Model Parameters on Finite Element Analysis of Micromotions in Implant Dentistry
Peri-Implant Defect Augmentation With Autogenous Bone: A Study in Beagle Dogs
Would Nitric Oxide be an Effective Marker for Earlier Stages of Peri-Implant Disease? An
The Effect of Different Surface Treatments on Cement-Retained Implant-Supported
Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation
Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical
The Bis-Acryl Stent
Clinical, Histological, and Histomorphometrical Analysis of Maxillary Sinus Augmentation
A Technique to Salvage a Single Implant-Supported Fixed Dental Prosthesis Having a
Ridge Expansion and Immediate Placement With Piezosurgery and Screw Expanders in
Pterygoid Implants for Maxillofacial Rehabilitation of a Patient With a Bilateral Maxillectomy
Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management
Fracture of Anterior Iliac Crest Following Bone Graft Harvest in an Anorexic Patient: Case
A Technique for Constructing a New Maxillary Overdenture to a Nonretrievable Implant
Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of

Journal of Oral Implantology February 2013