Computer-guided chin harvest: A novel approach for autogenous block harvest from the mandibular symphesis

Clin Implant Dent Relat Res. 2018 Aug;20(4):501-506. doi: 10.1111/cid.12610. Epub 2018 Apr 23.

Abstract

Background: The introduction of CAD/CAM technology allowed clinicians to carry out complex procedures with a high level of precision and reproducibility and minimize the risk of injury during the procedure.

Purpose: The aim of the present study is to evaluate the efficacy of the CAD/CAM surgical guide during chin harvesting procedures in reducing the risk of neurosensory damage and patient morbidity compared with the standard technique.

Materials and methods: About 20 cases of autogenous block chin harvest were randomly into two groups. The first group received computer-guided chin block harvest while the second group received autogenous block chin harvest using the standard approach.

Results: In the guided group, out of the 10 subjects, 2 subjects presented with wound dehiscence which resolved within 1 month. No teeth showed any negative pulp sensitivity results. The pointed-Blunt test and 2 point discrimination tests showed a single case of neurodeficits at 1 week follow-up appointment which resolved within 1 month. In the nonguided group, out of the 10 subjects, 1 case presented with wound dehiscence that resolved completely within 1 month. Pulp vitality test showed negative results in 29.4% of the involved teeth at 1 week which decreased to 9.8% and 3.9% at 1 and 6 months follow-up, respectively. The pointed blunt test revealed 3 subjects with neurodeficits at 1 week, out of which 2 subjects showed persisting symptoms at 6 months follow-up. The 2 point discrimination test showed 3 subjects with neurodeficits, out of which two subjects showed persistent symptoms with no resolution at the 6 months follow-up.

Conclusion: Within the limits of this study, computer-guided chin harvest shows promising results in the reduction of neurosensory complications following harvesting procedures and presents as a safe alternative to the standard technique.

Keywords: CAD/CAM technology; autogenous bone; chin graft; mandibular symphesis; morbidity.

MeSH terms

  • Adult
  • Bone Transplantation / methods
  • Chin / diagnostic imaging*
  • Chin / innervation
  • Chin / surgery*
  • Computer-Aided Design
  • Cranial Nerve Injuries / etiology
  • Dental Pulp / innervation
  • Facial Nerve Injuries
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Male
  • Mandible / diagnostic imaging*
  • Mandible / innervation
  • Mandible / surgery*
  • Mandibular Nerve
  • Middle Aged
  • Morbidity
  • Reproducibility of Results
  • Surgery, Computer-Assisted / methods*
  • Surgical Flaps
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*
  • Tooth / innervation
  • Trigeminal Nerve Injuries / prevention & control*