Palatal Bone Could be a Donor Site for Bone Augmentation

Objectives: Autogenous bone is still the gold standard for grafting. Palatal bone harvesting could be interesting for oral bone augmentations. The objective of this study is to determine radiologically and clinically on a cadaver if the palatal bone harvesting is a feasible and reproducible technique.
Methods: The radiologic analysis was performed with CBCT from the dental clinic of Nice Hospital. 100 patients aged 20 to 60 years were included. Measurements were carried out to define a sufficient volume of sample, respecting the 4 mm safety margins compared to dental roots next to the cut line, and a 2 mm safety margin to the overlying anatomic structures. First measurements characterized the bone height available at the second maxillary premolar, the canine and the incisor foramen to the floor of the nasal cavity. The anteroposterior measurement was between the incisal foramen and the line connecting the maxillary second premolars. For the cadaver study, a 58-year woman head with a complete dental formula was placed at our disposal at the Anatomy Laboratory of Nice Medical School. After elevation of the palatal flap, a corticocancellous bone fragment was harvested with a Piezotome® in the left palatine area regarding the incisor to the first premolar.
Results: The average bone height was 14.38 mm at canine and 10.84 mm at the second premolar. The average length was 15.61 mm between the incisive foramen and its intersection with the line between the second premolars. A corticocancellous palatal bone block of 12/10/5 mm was harvested easily and quickly from the human cadaver.
Conclusions: The palatal autologous bone graft is an interesting way through its anatomical position, its lower morbidity and the cortical bone volume available both as spongy. This study shows that palatal bone harvesting is a feasible and reproducible technique that makes sense in small extent pre-implant reconstructions, especially in the anterior maxilla.