Prof. Rainer Schmelzeisen, University of Freiburg, covers a bone defect in the anterior maxilla with an autologous bone block transplant, which is obtained from the patient’s mandible within the same session.
Prof. Schmelzeisen first harvests an autologous bone block and additional bone material from the mandible using the piezotome and chisel. Once the donor site is covered with a collagen fleece, the wound is securely closed.
For the exposure of the bone defect in the maxilla, a mucoperiosteal flap is elevated. The harvested bone graft is prepared according to the required size. The underlying bone at the recipient site is contoured and also perforated with a fine drill to improve blood circulation. Screw holes in the bone graft are extra-orally defined and pre-drilled. Then the bone block is placed, and screw holes are prepared at the maxillary alveolar bone before the screws are fixated. Sharp edges are smoothened, and gaps and unevenness between bone graft and alveolar ridge are filled and compensated with a mixture of bone chips and bone substitute material. The augmented region is covered with a collagen membrane. Finally, the mucoperiosteal flap is secured for a tension-free wound closure.