Comparative radiologic study of bone density and cortical thickness of donor bone used in mandibular reconstruction

Abstract

Objective: The aim of this study was to compare the total cancellous bone density, bone-implant interface density, and cortical thickness of 6 donor bone types commonly used in oral and maxillofacial reconstruction. Methods: A total of 120 bones from 20 Korean adults—including iliac bones, fibulas, cranial bones, scapulas, ribs, and clavicles—were selected. The implant recipient site was determined by the shape, contour, and anatomical limitations of the bones. The serial cross-sectional images of each bone were then acquired through computed tomography. Total cancellous bone density, bone-implant interface density around the imaginary implant fixture, and the cortical thickness along both sides of the imaginary fixture on each cross-sectional image were evaluated and compared. Results: The cancellous bone density of each donor bone type had a statistically significant difference. The cranial bone showed the highest cancellous bone density, followed by the iliac bone, clavicle, scapula, rib, and fibula (P < .05). The bone-implant interface density of the cranial bone, clavicle, fibula, and scapula each belonged to the same Duncans group, whereas the rib and iliac bone showed lower bone-implant interface density. In average cortical thickness, the scapula and fibula had a thicker cortex surrounding the imaginary implant than the other bones, and the rib had the thinnest cortex. Conclusion: Although more extensive testing is needed to explain the clinical implications of these results, the findings of this study may help clinicians choose the most appropriate donor bone.