Palatal Core Graft for Alveolar Reconstruction: A New Donor Site

Purpose: A simple technique is described for alveolar reconstruction in cases where resorption has already occurred. The palatal core graft allows immediate regeneration of vertical, horizontal, and combined defects at the alveolus with minimal donor site morbidity and time consumption. Materials and Methods: Seventeen patients (10 female and 7 male) were treated over a 1-year period. Bone core grafts from the palatal vault were harvested with a trephine and used for alveolar reconstruction in the esthetic zone. Patient age and gender, type and location of the defect, size of the graft, simultaneous tooth removal, simultaneous implant placement, need for soft tissue coverage, and postoperative complications were recorded. Results: Mean length of the grafts was 12.5 mm (range 9 to 14 mm). Mean width was 7.3 mm (range 5 to 9 mm). In 11 cases, simultaneous tooth removal was performed and a connective tissue flap with posterior pedicles was used. Patients did not experience discomfort in the donor area. Sixteen cases were successfully restored with single implants and crowns Discussion: Material for osseous reconstruction should ideally be autologous and easy to harvest and provoke minimal morbidity. The palatal core graft compares favorably with previously described techniques and donor sites for alveolar reconstruction. Conclusion: In this preliminary report, experience with a new technique for alveolar reconstruction is presented. The "palatal core graft" for alveolar reconstruction is effective and easy to harvest and has low donor site morbidity, allowing 3-dimensional restoration of alveolar defects. Keywords: alveolar reconstruction, bone grafting, immediate implant placement