Autogenous regional bone grafting as an adjunct in orthognathic surgery.

Three cases have been presented that demonstrate some ways in which adjacent autogenous bone can be used for grafting in orthognathic surgery. The limitations on the use of such bone are, of course, the amount and type of bone available and the imagination of the surgeon. Cases that require larger quantities or specific types of bone, i.e., cancellous or cortical bone, may dictate use of more distant sites such as the iliac crest or rib. Finally, use of contiguous bone requires careful preoperative surgical osteotomy design and prediction. Known benefits of using adjacent bone are avoidance of a distant surgical site and the attendant morbidity. However, the potential advantages of a bone graft that is embryologically, histologically, or functionally similar to the recipient site are not yet known. The significance of grafting from one growth field (depository or resorptive) to a similar field also awaits study.