The block graft is temporarily stored in sterile saline while the donor site is closed. Direct pressure is applied for 3-5 minutes to aid in tissue adaptation and control hemostasis. A pressure dressing is placed over the chin to help support the donor site and minimize edema. Keep the graft submerged in sterile saline while trimming to minimize dessication and overheating. Osteoplasty of the recipient site may also be necessary for graft adaptation.
Intramarrow penetration is performed in the recipient site using a small round bur.
Fixate the block to the recipient site using bone stabilization screws placed into the previously drilled pilot holes. Countersinking the fixation screw will minimize the risk of the head of the stabilization screw perforating the soft tissue and will serve as a reference point to determine graft resorption. Most clinicians will use either a bioabsorbable or non-resorbable membrane to cover the block graft. Complete tension-free soft tissue coverage of the block graft is essential for success. The chin dressing is removed in 3-4 days.