Prefabricated Iliac Crest Transplant

PurposeOur aim was to augment the extremely atrophic mandibular alveolar crest with a pedicled transplant as the best option for a satisfactory preprosthetic outcome.Materials and MethodsAfter computed tomography of the mandible, a model was milled for 6 patients. The iliac crest transplant with its vascular pedicle was harvested and, after preliminary preparation, fixed to the model. The transplant was then placed in the axilla. After 3 months, the graft was removed and fixed to the mandible.ResultsThe prefabricated transplant fit exactly in all 6 patients. The length of the pedicle and coverage with the newly developed alveolar mucous membrane were satisfactory. The grafts allowed prosthetic reconstruction with good functional outcomes. No bone loss was observed during 7 years of follow-up. Additionally, indocyanine green angiography showed good perfusion in 4 patients after 6 months.ConclusionsThe results suggest that carefully prefabricated pedicled transplants can augment an atrophied mandibular alveolar crest.