Mandibular onlay grafting using prefabricated bone grafts with primary implant placement: an experimental study in minipigs

The aim of this experimental study was to evaluate the use of prefabricated autogenous bone grafts as onlay grafts to the mandible. Excess bone of 10 x 12 x 40 mm was produced inside blocks of pyrolyzed bovine bone under a polylactic membrane coverage on the outside of the mandible in 15 adult G?ttingen minipigs. After 5 months, this bone was harvested and transferred to the premolar region of the mandibular body in 10 animals. Onlay grafts of mandibular bone were used as controls for the transplanted prefabricated grafts. All grafts were fixed by primary placement of one titanium implant each. Five animals served as ungrafted controls. Evaluation was performed after 3 months and 5 months, respectively. Two animals were lost to evaluation, and one scaffold became infected. Eleven of the remaining 12 scaffolds showed sufficient bone ingrowth for grafting. Three months after transplantation, bone volume of the prefabricated grafts was almost completely preserved, with only minimal resorption in the superficial pores of the scaffolds, while the control grafts exhibited partial resorption. The titanium implants, which had been placed at the time of only grafting, exhibited direct bone-implant contact. Five months after grafting, all titanium implants showed complete osseointegration, with direct bone-implant contact. The grafted bone exhibited a significant increase in bone density by appositional bone formation. The control grafts were nearly completely resorbed at that time.