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Block bone graft (ramus graft)
In some particilar case, you have not enough bone for implant placement because of tooth loss from periodontal (gum) disease, injury or trauma, or a developmental defect. If your jaw is too short (up and down), too narrow (side to side), or both, you will need a procedure to add bone to your jaw before implant placement.

Indications for the mandibular ramus as a donor site include localized moderate to severe alveolar atrophy or a bone defect involving a one to four edentulous span. The anatomical proximility makes the ramus the site of choice for augmentation of the thin posterior mandible.


Surgeon: DDS, MDS Vo van Nhan
Patient: a 43 year old man, non-smoker. The patient was in good health and missing tooth 46.

ramus graft
missing tooth 46
Based on the clinical and radiographic finding, it was decided bone graft into tooth 46 with both autogenous bone and synthetic bone substitute material. The donor site is ramus.

ramus graft  
The implant was placed in an ideal three-dimensional position but distance between the socket walls and the implant body, we need to fill the gap with  both autogenous bone and synthetic bone substitute material. 
ramus graft ramus graft
 Block bone graft is harvesed  to fill the gap with  both autogenous bone and synthetic bone substitute material.
After implant placement and bone graft 6 months, soft tissue was reopened to exposed implant to prepare final crown on the implant. This figure showed both implant and bone graft were well integrated.
ramus graft
both implant and bone graft were well integrated
3 weeks later the final crown was inserted by the final matel ceramic cement retined crown.
ramus graft
 The final crown on the implant

The surgical procedure and final crown on the implant were performed by Dr Vo Van Nhan

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