Cancellous bone block allografts for the augmentation of the anterior atrophic maxilla

Clin Implant Dent Relat Res. 2011 Jun;13(2):104-11. doi: 10.1111/j.1708-8208.2009.00193.x.

Abstract

Background: Pre-implant augmentative surgery is a prerequisite in many cases in the anterior maxilla to achieve a stable, long-term esthetic final result.

Purpose: The aim of the present study was to evaluate the outcome of ridge augmentation with cancellous freeze-dried block bone allografts in the anterior atrophic maxilla followed by placement of dental implants.

Materials and methods: Thirty-one consecutive patients were included in the study. A bony deficiency of at least 3 mm horizontally and up to 3 mm vertically according to computerized tomography (CT) served as inclusion criteria. Sixty-three implants were inserted after a healing period of 6 months. Nineteen of sixty-three implants were immediately restored. Bone measurements were taken prior to bone augmentation, during implant placement, and at second-stage surgery.

Results: Forty-six cancellous allogeneic bone blocks were used. The mean follow-up was 34 ± 16 months. Mean bone gain was 5 ± 0.5 mm horizontally, and 2 ± 0.5 mm vertically. Mean buccal bone resorption was 0.5 ± 0.5 mm at implant placement, and 0.2 ± 0.2 mm at second-stage surgery. Mean bone thickness buccal to the implant neck was 2.5 ± 0.5 mm at implant placement, and 2.3 ± 0.2 mm at second-stage surgery. There was no evidence of vertical bone loss between implant placement and second-stage surgery. Block and implant survival rates were 95.6 and 98%, respectively. All patients received a fixed implant-supported prosthesis.

Conclusion: Cancellous block allografts appear to hold promise for grafting the anterior atrophic maxilla.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alveolar Process / pathology
  • Alveolar Ridge Augmentation / methods*
  • Atrophy
  • Bone Matrix / transplantation
  • Bone Transplantation / methods*
  • Collagen / therapeutic use
  • Dental Implants
  • Dental Prosthesis, Implant-Supported
  • Esthetics, Dental
  • Female
  • Follow-Up Studies
  • Freeze Drying
  • Graft Survival
  • Humans
  • Immediate Dental Implant Loading
  • Male
  • Maxilla / pathology
  • Maxilla / surgery*
  • Membranes, Artificial
  • Middle Aged
  • Minerals / therapeutic use
  • Osseointegration / physiology
  • Surgical Wound Dehiscence / etiology
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Bio-Gide
  • Bio-Oss
  • Dental Implants
  • Membranes, Artificial
  • Minerals
  • Collagen