Quantitative Evaluation of Zygomatic Buttress, Ramal, and Symphysis Onlay Grafts in Ridge Augmentation Prior to Implant Placement

Dental implants require an adequate amount of bone volume for successful and good prosthetic support. However, in severe alveolar bone width deficiency, onlay grafts from intraoral donor sites like zygomatic buttress, ramus and symphysis may be taken.

A prospective comparative study was conducted on 30 patients with upper and lower anterior edentulous arches of width less than 4 mm. They were evaluated for the efficacy of three types of onlay grafts for ridge augmentation prior to implant placement. Patients were randomly divided into Group 1 (Ramal), Group 2 (Symphysis) and Group 3 (Zygomatic buttress) grafts of n = 10 each. The grafts were evaluated in terms of bone width, pain, mouth opening, teeth vitality, neurosensory loss and patient satisfaction score till 6 months follow-up.

Graft uptakes were good in all three groups with maximum width gained in the symphysis group. More postoperative complications (reduced mouth opening, swelling, paresthesia, mobility) occurred in the ramal graft group.

The use of autogenous onlay bone grafts from intra-oral donor sites provides promising results with reduced operative time for augmenting atrophic ridge prior to implant placement, but the symphysis graft provides the maximum bone width to accommodate the dental implant, with minimal complications.