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Block bone graft (iliac crest bone graft)
The iliac crest is the curved ridge at the top of the pelvic bone.The iliac crest is a particularly important bone structure in medicine, as it contains large amounts of bone marrow.

The large amount of bone that makes up the iliac bone crest is also sometimes used as a source for bone grafts. It can provide, for example, sufficient volumes of bone for many types of facial reconstruction surgery. The iliac crest posterior region, at the back of the hip, provides particularly large volumes of bone.
 
CLINICAL CASE

Surgeon: DDS, MDS Vo Van Nhan
Patient: a 50 year old man patient, healthy was in good and smoker. The missing teeth on upper jaw had been absent for 10 years therefore, the alveolar process showed a marked lateral deficiency because of horizontal bone resorption. 
illiac crest bone graft
 almost of teeth was losed
illiac crest bone graft
 The radiographic showed bone loss
CT cone beam was taken to evaluate jaw bone density exactly.
illiac bone graft
 CT cone beam showed the anterior area in three- dimension severe bone loss
 illiac bone graft

illiac bone graft  
Cross-section  of 12 tooth
 illiac bone graft

illiac bone graft  
Cross-section  of tooth 11

illiac bone graft illiac bone graft
 Cross-section  of tooth 23
illiac bone graft illiac bone graft
 Cross-section  of tooth 24
Based on radiographic, the width and the height of jaw bone is not enough to place implant.

 Tooth position  The width
(mm)
The height
(mm)
 12  5.7  2.3
 11  4.4  0.9
 22  8.2  1.0
 23  18.1  1.5
Treatment plan

- 6 implants on upper jaw
- 2 mini implants to support temporary teeth
- Block bone graft and sinus lift
- The time to finish treatment plan is about 6 months

Because the anterior area has severe bone loss, implants will be placed into the back side. In this particular case, the volume of the maxillary sinus enlarge so grafting on the maxillary sinus floor incerases the vertical height of the posterior maxillary bone prior to implant placement. 

The volume of the maxillary sinus is large so bone graft procedure was performed with autogenous bone material which harvested from iliac crest. 
Block bone graft (iliac crest bone graft)
Iliac crest bone graft

illiac bone graft illiac bone graft
 iliac crest is harvested
 grafting on the maxillary sinus
illiac bone graft  
 After augmentation procedure, the radiographic was taken to check implants
 
To make sure implants were in ideal three-dimensional position, CT cone beam was taken to check implant.

illiac crest bone graft illiac crest bone graft illiac crest bone graft
The radiographic oh tooth 14  The radiographic oh tooth 15  The radiographic oh tooth 16

illiac crest bone graft illiac crest bone graft illiac crest bone graft
 The radiographic oh tooth 24
 The radiographic oh tooth 26
 The radiographic oh tooth 27
After implant placement 1 week, the patient return to our office to put the temporary teeth on mini implant and check healing wound.
illiac crest bone graft
 Temporary teeth on the mini implant

illiac bone graft
 The wound was well healing after implant placement 1 week
After implant placement 3 months, the patients return to check healing wound again. The radiographic showed both implant and bone graft were well integrated.
illiac crest bone graft illiac crest bone graft
 Healing wound after 3 months
 The gradiographic after 3 months
About 6 months after sugery, soft tissue was reopened to prepared final crown on the implants.
illiac crest bone graft illiac crest bone graft
 To try a metal frame
 The radiographic was taken to check metal frame

illiac crest bone graft illiac crest bone graft
 Bridge on the implant
 The radiographic was taken to check bridge on the implant

illiac crest bone graft illiac crest bone graft
 Before  After






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Nhan Tam Dental Clinic – Dental Implant And Cosmetic Restoration
Address: 807, 3/2 Street, Ward 7, Dist. 10, Ho Chi Minh City, Viet Nam - Tell: (+ 84) 8 3957 0229 –  (+84) 8 3957 5569 . Mobile (+84) 903.632701 (+84) 938.344970 
Website: www.nhakhoanhantam.com - www.implantvietnam.info - Email: drnhan@hotmail.com – drnhan1@gmail.com - Copyright © 2008 by Nhan Tam Dental Clinic