Efficacy of cancellous block allograft augmentation prior to implant placement in the posterior atrophic mandible

Clin Implant Dent Relat Res. 2011 Dec;13(4):279-85. doi: 10.1111/j.1708-8208.2009.00219.x. Epub 2009 Aug 5.

Abstract

Background: The present study evaluated the outcome of ridge augmentation with cancellous freeze-dried block bone allografts in the posterior atrophic mandible followed by placement of dental implants.

Materials and methods: A bony deficiency of at least 3 mm, horizontally, vertically, or both, according to computerized tomography (CT) para-axial reconstruction served as inclusion criteria. Implants were inserted after a healing period of 6 months. Bone measurements were taken prior to bone augmentation, during implant placement, and at second-stage surgery. Marginal bone loss and crown-to-implant ratio were also measured.

Results: Twenty-nine cancellous allogeneic bone blocks were placed in 21 patients. The mean follow-up was 37 months. Bone block survival rate was 79.3%. Mean horizontal and vertical bone gains were 5.6 and 4.3 mm, respectively. Mean buccal bone resorption was 0.5 mm at implant placement and 0.2 mm at second-stage surgery. A total of 85 implants were placed. Mean bone thickness buccal to the implant neck was 2.5 mm at implant placement and 2.3 mm at second-stage surgery. There was no evidence of vertical bone loss between implant placement and second-stage surgery. Implant survival rate was 95.3%. All patients received a fixed implant-supported prosthesis. At the last follow-up, the mean marginal bone loss was 0.5 mm. The mean crown-to-implant ratio was 0.96.

Conclusion: Implant placement in the posterior atrophic mandible following augmentation with cancellous freeze-dried bone block allografts may be regarded as a viable treatment alternative.

MeSH terms

  • Absorbable Implants
  • Adult
  • Aged
  • Alveolar Ridge Augmentation / methods*
  • Atrophy
  • Bone Substitutes / therapeutic use
  • Bone Transplantation / methods*
  • Cephalometry / methods
  • Dental Implantation, Endosseous / methods*
  • Dental Implants
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Female
  • Follow-Up Studies
  • Freeze Drying
  • Graft Survival
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Male
  • Mandible / pathology
  • Mandible / surgery*
  • Membranes, Artificial
  • Middle Aged
  • Radiography, Panoramic / methods
  • Survival Analysis
  • Tomography, X-Ray Computed / methods
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Bone Substitutes
  • Dental Implants
  • Membranes, Artificial