Journal of Oral Implantology August 2013 - (Page 463)

CLINICAL Minimal Iliac Bone Harvesting in Sinus Lift Surgery ´ry* G. Thie N. Lari S. Adam F. Salles For sinus grafting, the authors propose a minimal posterior iliac bone harvesting, with local anesthesia. Autogenous bone grafting continues to be considered the gold standard for sinus grafting. The classic harvesting sites are calvarial, anterior iliac, and tibial, and harvesting is usually practiced under general anesthesia. We performed this technique in 7 patients under local anesthesia. In the posterior iliac crest, with a specific trocar for bone puncture biopsy, bone was harvested. We performed 1 cm longer for 5-mm diameter of bone. Three bone biopsies were harvested on each side. The harvested cancellous bone (5 cm3) was mixed with triphosphocalcic (TCP) material (2 cm3), and blood (1 cm3). A classic sinus lift was realized. After 6 months, the success rate of bone grafting was 100%. Each of the 7 patients could be implanted by an average of 4 dental implants by superior maxillary. For sinus lift, this simple posterior iliac-bone biopsy harvesting under local anesthesia is very comfortable for the patient and also safe. It provides enough marrow bone to be mixed with TCP for a sinus lift. Key Words: bone grafting, iliac, local anesthesia, sinus lift INTRODUCTION I n cases of severe atrophy of the maxillary alveolar process, the sinus lift surgery1 allows for implant insertion. Autogenous bone grafting continues to be considered the gold standard for sinus grafting.2 General anesthesia is often required. However, in some cases, the patient’s health does not permit such anesthesia, or the patient may refuse this general anesthesia. Some authors have already described iliac bone harvesting with manual or electric trephine.3 These techniques concern only cortical bone. In our technique, we harvest cancellous bone rich in osteoblasts. Other authors propose local anesthesia to harvest the anterior iliac crest.4 This technique results in a painful postoperative period because of the large quantity of bone required. In our technique, the quantity of autogenous bone is reduced because we mix it with triphosphocalcic (TCP) material. ˆ Department of Maxillofacial Surgery, Hopital d’Instruction des ´ ´ Armees, Armees, France. * Corresponding author, e-mail: thiery.gaetansophie@free.fr DOI: 10.1563/AAID-JOI-D-09-00002 Our minimal iliac bone harvesting technique is new and presents many advantages: the use of local anesthesia; cancellous bone harvesting, which is easy to perform; painlessness of the procedure; reduced quantity of bone required because of the mix with TCP material; and reduction in scars due to the transcutaneous trocar. Technical method The patient is premedicated with light anxiolytic per os (hydroxyzine [Atarax] 50 mg, 1 hour before the operation) and initially placed in the ventral position. The iliac crest is palpated from forward to behind. The superior-posterior iliac spine site is repaired, which is the harvesting site. The landmarks are positioned laterally of the crest. The cutaneous, muscular, and cortical planes are infiltrated with 3 mL of Xylocaine adrenaline (lidocaine epinephrine 2%). The specific trocar for bone puncture biopsy (trocar Jamshidi for medullar biopsy, ref IT12306, Holtex, Aix-en-Provence, France) is introduced directly percutaneously (Figure 1). This trocar is usually used for bone biopsy in internal medicine. A handheld trephine was used. One centimeter longer for a 5-mm diameter of bone is harvested. Three Journal of Oral Implantology 463

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

Literary Responsibility—Everyone Has a Role to Play
Rehabilitation of Surgically Relocated Integrated Dental Implants With and Without Bone Morphogenesis Protein-2
Erratum
Marginal Fit of Implant-Supported All-Ceramic Zirconia Frameworks
Influence of the Implant Diameter With Different Sizes of Hexagon: Analysis by 3-Dimensional Finite Element Method
Autologous Dental Pulp Stem Cells in Regeneration of Defect Created in Canine Periodontal Tissue
Histologic and Biomechanical Evaluation of 2 Resorbable-Blasting Media Implant Surfaces at Early Implantation Times
Efficacy of Guided Bone Regeneration Using Composite Bone Graft and Resorbable Collagen Membrane in Seibert’s Class I Ridge Defects: Radiological Evaluation
Minimal Iliac Bone Harvesting in Sinus Lift Surgery
Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants
Ultrasonic Oscillations for Conservative Retrieval of a Rare Fracture of Implant Healing Abutment
Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
Gingival Conditioning in an Implant-Supported Prosthesis: A Clinical Report
An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report
Computer Guided Surgery for Implant Placement and Dental Rehabilitation in a Patient Undergoing Sub-Total Mandibulectomy and Microvascular Free Flap Reconstruction
Guided Bone Regeneration for Socket Preservation in Molar Extraction Sites: Histomorphometric and 3D Computerized Tomography Analysis
Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review
Review of Current Literature

Journal of Oral Implantology August 2013