Dental implants placed in severely atrophic jaws reconstructed with autogenous calvarium, bovine bone mineral, and collagen membranes: A 3- to 19-year retrospective follow-up study

Clin Oral Implants Res. 2018 Jul;29(7):725-740. doi: 10.1111/clr.13281. Epub 2018 Jun 7.

Abstract

Objectives: To present the clinical, radiographic, and patient-related outcomes of patients presenting with severely resorbed ridges reconstructed with autogenous calvarial bone blocks and rehabilitated with implant-supported prostheses.

Material and methods: From 1998 to 2014, 72 patients presenting with severe bone defects were reconstructed with autogenous calvarial bone blocks covered with bovine bone mineral granules and collagen membranes. Four to 9 months later, 330 implants were placed and loaded 3-9 months later. The follow-up ranged from 3 to 19 years (mean: 8.1 years). The following parameters were recorded: (a) complication rate of the reconstructive procedure; (b) bone resorption before implant placement; (c) implant survival rate and implant-related complications; (d) peri-implant bone resorption; and (e) patient's satisfaction inquired with a dedicated questionnaire.

Results: No patients developed severe complications, such as complete loss or resorption of the grafts. A dehiscence occurred in six patients, which developed a mild graft resorption. The mean peri-implant bone resorption before implant placement was 0.13 mm (SD ± 0.71). All patients received the planned number of implants. Three patients were lost during the follow-up. The survival rate of implants at the end of the observation period was 98.5%. The mean peri-implant bone resorption ranged from 0.00 to 4.87 mm (mean: 1.11 mm). At last, 90% of the patients were very satisfied as regards the treatment received.

Conclusions: Results from this study suggested that: (a) bone volume in the areas reconstructed with calvarial grafts was stable over time; (b) survival rates of implants were consistent with those reported for implants placed in native bone; (c) patient's satisfaction was high.

Keywords: autogenous bone; bone atrophy; bone reconstruction; calvarium; complication; dental implant; patient satisfaction.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alveolar Bone Loss / surgery*
  • Alveolar Ridge Augmentation / methods*
  • Animals
  • Bone Density
  • Bone Substitutes / therapeutic use*
  • Cattle
  • Collagen / therapeutic use*
  • Dental Implantation, Endosseous / methods*
  • Dental Implants*
  • Dental Prosthesis, Implant-Supported / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Jaw, Edentulous, Partially / surgery
  • Male
  • Mandibular Reconstruction
  • Middle Aged
  • Retrospective Studies
  • Skull / transplantation*
  • Young Adult

Substances

  • Bone Substitutes
  • Dental Implants
  • Collagen