Multi-Tier Technique for Bone Augmentation Using Intra-Oral Autogenous Bone Blocks

Objectives: Intra-oral bone grafts are a convenient and acceptable source of autogenous bone for alveolar reconstruction due to bone origin similarity and less morbidity. In large bone defects, one tier might be insufficient to achieve the desired bone shape. The purpose of this article was to describe a multi-tier technique for reconstruction of extensive bone deficiency, using only intra-oral block bone grafts prior to dental implantation. Methods: After clinical and radiographic evaluation of the recipient site, measurements were taken to determine the size of the bone deficiency. The first tier of bone graft was harvested from the mandibular ramus. After additional clinical and radiographic evaluation of the recipient site 5 months later, bone graft blocks for the second tier were harvested from the mandibular symphysis. Results: Use of bone from the mandibular symphysis, retromolar area, and mandibular ramus, can serve as a good treatment alternative for alveolar ridge augmentation. The present report describes a multi-tier intra-oral onlay bone block graft that can serve as a predictable alternative operation for extensively absorbed ridge augmentation. Conclusions: A new technique, the “multi-tier intra-oral bone block graft”, can be used to overcome the limitation of available bone required for dental implantation in extensively absorbed alveolar bone.