A radiographic analysis of the anterior palate as a donor site for bone harvesting
Autologous bone grafting in conjunction with dental implant therapy is a well-accepted procedure in oral and maxillofacial rehabilitation. A variety of intraoral donor sites, such as the mandibular symphysis, the mandibular ramus and the maxillary tuberosity have been used in oral and maxillofacial reconstruction. However these sites are associated with complications. In order to reduce these complications, the anterior palate has been proposed as a potential donor site. However, the scientific literature in this regard is sparse, and larger studies are required to investigate the clinical potential of this proposed site. Aim: To determine the volume and density of available bone in the anterior palate that may be used for bone harvesting using cone-beam computed tomography (CBCT) in a select South African population. Materials and methods: One hundred previously acquired CBCT scans taken at the Diagnostic and Radiology Department of Tygerberg Oral Health Centre were analyzed for the required data. These were all acquired from a single CBCT machine (Newtom VGI®, Verona, Italy). The study sample included 52 females and 48 males ranging from ages 20 years to 80 years. The CBCT scans were divided into 3 different age groups. The first age group was between the ages of 20 and 39 years, the second age group was from 40 to 59 years and the third age group was ≥ 60 years. The volume and density of the anterior palate of the different age groups were analyzed using specific criterion. CBCT specific software (Simplant Pro Crystal®) Dentsply implants, Mannheim, Germany was used to standardize the data collection. All data was stored in a Microsoft Excel spreadsheet (Microsoft Corporation, Washington, USA). Results: The mean volume of the anterior palate in this study was 2.11 ± 0.55 cm3, with a minimum volume of 1.04 cm3 and a maximum volume of 3.82 cm3. There was no significant difference in the volume and density of the anterior palate between different age groups and no significant difference in the volume between males and females (p value = 0.227). Conclusions: The anterior palate affords a considerable amount of bone volume which is similar or even more than other intraoral donor sites. The anterior palate is a potential donor site for bone harvesting and CBCT may be regarded as an ideal tool to analyze the amount of bone available for harvesting.