Comparison of intraoral harvest sites for corticocancellous bone grafts

Purpose: The aim of this study is to quantify and compare the amount of bone that can be harvested from the mandibular symphysis, ascending ramus/body, coronoid process, and the zygomatic-maxillary buttress using a within-subject study design. Materials and Methods: Three continuous outcomes (area, thickness, and volume) were measured at 4 sites (zygomatic-maxillary buttress symphysis, ramus, coronoid) from each of the 59 cadavers used in this study. The explanatory variables were age, gender, and site. To account for the within-subject research design, a linear mixed-effects model was performed separately for each of the 3 outcomes to compare the sites controlling for age and gender. Level of significance was set at 0.05. Results: For all 3 outcomes, there was a statistically significant difference among the average values of the 4 sites (P < 0.0001). The ramus had the highest average cortical bone area and volume harvested, while the symphysis had the highest average thickness. Conclusions: The characteristics among different potential intraoral donor sites vary greatly regarding thickness, volume, and cortical surface area. Using the estimates of the various yields derived from these grafts, a surgeon will be more adequately equipped to confront the reconstructive challenges of the maxillofacial region.