Dental implants – pertinent papers 2003–2004 (original) (raw)
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Maxillary bone grafting for insertion of endosseous implants: results after 12-124 months
Clinical Oral Implants Research, 2001
Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone graft has been proven to be a reliable treatment modality, at least in the short term. The long-term clinical and radiographic outcome with regard to the grafts, the implants and satisfaction of the patients with their implant-supported overdenture was studied in 99 patients. The sinus floor was augmented with bone grafts derived from the iliac crest (83 subjects, 162 sinuses, 353 implants), the mandibular symphysis (14, 18, 37), or the maxillary tuberosity (2, 2, 2). Before implant installation, the width and height of the alveolar crest were increased in a first stage procedure in 74 patients, while in the other 25 patients augmentation and implant installation could be performed simultaneously (width and height of the alveolar crest Ͼ5 mm). Perforation of the sinus membrane occurred in 47 cases, which did not predispose to the development of sinusitis. Loss of bone particles and sequestration were observed in one (diabetic) patient only, in whom a dehiscence of the oral mucosa occurred. A second augmentation procedure was successful in this patient. Symptoms of transient sinusitis were observed in 3 patients. These symptoms were successfully treated with decongestants and antibiotics. 2 other patients developed a purulent sinusitis which resolved after a nasal antrostomy. In all cases, the bone volume was sufficient for implant insertion. 32 of 392 inserted Brånemark implants (8.2%) were lost during the follow-up. After the healing period of the bone grafts, no sinus pathology was observed. The patients received implant-supported overdentures (72 patients) or fixed bridges (27 patients). Overall, the patients were very satisfied with the prosthetic construction. We conclude that bone grafting of the floor of the maxillary sinus floor with autogenous bone for the insertion of implants is a reliable treatment modality with good long-term results.
Follow-Up of Dental Implants placed in Onlay Bone Graft
Objective: Onlay bone grafting (OBG) using autologous bone blocks is an accepted method for the reconstruction of atrophic alveolar ridges. Method: A retrospective study was conducted on 250 patients' files (mean age at OBG surgery 50.3±15.5, 179 females) who received a total of 727 dental implants placed in 262 augmentations using OBG from 1999 to 2010. All the augmentations and implant placement procedures were performed by a single surgeon (DSA), and all the bone blocks were of intra oral origin (mandibular ramus and symphesis). Follow up time was up to 140 months (mean follow up time 44.4±34.9 months). Result: File data indicated that 254 OBG were successful (96.9%). Bone graft exposure was shown to be moderately associated with bone graft failure (χ2=3.76, p=0.052). Dental implants placed in OBG showed a success rate of 93.7%, with most failures (78.2%) occurring at the prosthetic phase. significant differences in implant success rates were noted between genders, posterior ...
Annals of Periodontology, 2003
Background: Grafting the floor of the maxillary sinus has become the most common surgical intervention for increasing alveolar bone height prior to the placement of endosseous dental implants in the posterior maxilla. Outcomes of this procedure may be affected by specific surgical techniques, simultaneous versus delayed implant placement, use of barrier membranes over the lateral window, selection of graft material,
Maxillary reconstruction to enable implant insertion: a retrospective study of 181 patients
Head & Face Medicine, 2008
Background: The purpose of the present study was to evaluate different types of maxillary preprosthetic surgery using autogenous bone graft and suggest a guideline for maxillary reconstruction to place implant. Methods: 181 patients (125 females and 56 males), age range from 16 to 76 years old, were operated at the Maxillo-Facial Service of the Lille's 2 Universitary Hospital Center (Chairman Pr Joël Ferri). Different techniques were used, but always with autogenous bone grafting. 21 patients underwent a Lefort 1 procedure, 139 underwent sinus graft with or without vestibular onlay graft and 21 underwent onlay graft. This surgical procedure was made to allow the insertion of 685 implants. Results: The patients were evaluated by clinical and radiological assessment. In the cases of Lefort 1, the rate of successful osteointegration was higher when the implants were placed in the second part of a two stages procedure: 92%, against 81% for one stage. In cases of sinus lift procedure, the rate of implant success was 98%. The infection rate was 3.5%. There was no significant resorption and the type of prosthesis used was a denture retained by a bar or fixed bridge. In cases of onlay graft, the implant insertion success was 97% and there was no infection. The amount of resorption was more significant in the pre-maxilla than in the other areas and the type of prosthesis used was fixed dentures. Conclusion: These observations demonstrate that: the aetiology of the bone defect indicate the type and number of the surgical procedures to re-established good jaws relationship and give the bone conditions to implant insertion successful. Clinical Relevance: A guideline for surgical decision in the maxillary reconstruction for oral rehabilitation by implants may help to prevent failures of osseous resorption disorders and to foresee the investment of the bone in quality and necessary quantity.
Clinical Oral Implants Research, 2009
Aims/Background: For sinus floor augmentation and simultaneous implant placement, a minimum of 5 mm of residual bone height has been recommended empirically. This study was designed to test this assumption in an experimental animal trial. Material and methods: In eight mini pigs, three premolars and two molars were removed on one side of the maxilla. Three months later, the animals were assigned to four groups of two animals each. A cavity was created at the base of the alveolar process so that the residual bone height was reduced to 2, 4, 6 and 8 mm, respectively. Six implants were installed and an inlay augmentation procedure was carried out using a particulated iliac bone graft. Implants were loaded with fixed provisional restorations after a healing period of 6 months. The animals were sacrificed after 6 months of functional loading. Histologic specimens were prepared and histomorphometric analysis was performed [bone-to-implant contact (BIC) ratio, interthread bone area, peri-implant bone area, crestal bone resorption (CBR)]. Results: Two implants were lost during follow-up and fibrous encapsulation was detected in one additional implant. All failures occurred in one animal with a residual alveolar height of 2 mm. On the buccal aspect, BIC turned out to be significantly higher for 6 mm when compared with 2/4 mm (75.8 AE 26.1 vs. 58 AE 23.2/53.9 AE 22.8; Po0.05), while on the palatal aspect, BIC was significantly higher for 6/8 mm when compared with 2/4 mm (80 AE 17.8/ 78.9 AE 10.3 vs. 55.8 AE 26.5/55.6 AE 21.3; Po0.05). For an alveolar height of 8 mm, CBR tended to be significantly lower than for bone heights of 2/4 mm (3.8 AE 2.3 vs. 5.3 AE 2.6/5.8 AE 3.9; Po0.05). Correlation analysis revealed a significant association of BIC and interthread bone area as well as a negative association to CBR on the palatal aspect. Conclusion: The results of the present study show that the combination of maxillary inlay grafting and simultaneous implant placement does not hinder osseous integration even though the alveolar crest has been reduced to a residual height of 4 mm and below. However, according to histomorphometry, the highest predictability is gained in sites with residual bone heights of 6 and 8 mm.
International Journal of Oral & Maxillofacial Implants, 2022
I mprovements in dental implants have made the esthetic and functional replacement of natural teeth possible. Despite these advancements, the loss of teeth in the posterior maxilla results in the continual resorption of the maxillary alveolar ridge and the pneumatization of the maxillary sinus, diminishing the available bone height for implant placement. 1 In addition, bone quality in the posterior maxilla lacks strength because of its low-density medullary characteristics. 2 These physical properties of the posterior maxilla provide unique challenges to the surgeon placing implants. To compensate for this lack of bone quality and quantity in the posterior maxilla, sinus augmentation techniques are often used to create additional bone. 3 Among the many factors that affect the ability to achieve initial implant stability, residual ridge height in this region will determine whether a direct or indirect sinus elevation procedure is indicated. 1,4 Complications to the sinus elevation bone graft technique with implant placement include acute sinusitis, 5 facial