Unprotected autogenous bone block grafts in anterior maxilla: Resorption rates and clinical outcomes

INTRODUCTION/OBJECTIVES: The aims of this study were to analyze resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes; to assess stability of implants placed into the grafted bone and to monitor its changes during the healing period. METHODS: Study sample included 18 patients with total of 20 grafted sites. Residual alveolar ridge was measured before and after the augmentation and prior the implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. RESULTS: The average period from ridge augmentation to re-entry was 5.4 months (range 4- 6 months). At re-entry the healed alveolar ridge had a mean width of 6.1± 1,27 mm. The mean calculated width gain was 3.04 ± 1,22 mm. The overall surface resorption of block grafts was 0.68 ± 0,69 mm (18.85%). At the time of implant placement the mean value of implant stability was 71.25 ± 5.77 ISQ. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until 12th week. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p<0.05 Wilcoxon signed ranks test). During the follow-up period of 3 years no cases of implant loss were recorded. CONCLUSIONS: Despite significant resorption of bone grafts, it was possible to place implants in all cases and to use immediate loading protocol without affecting implant survival rate. [Projekat Ministarstva nauke Republike Srbije, br. 175021]

[1]  M. Karl,et al.  Osstell Resonance Frequency Measurement Values as a Prognostic Factor in Implant Dentistry. , 2015, The Journal of oral implantology.

[2]  N. Lang,et al.  Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: II. Implant surface modifications and implant diameter. , 2010, Clinical oral implants research.

[3]  C. Sim,et al.  Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length. , 2010, Clinical oral implants research.

[4]  R. Glauser,et al.  Immediate vs. early loading of dental implants: 3-year results of a randomized controlled clinical trial. , 2010, Clinical oral implants research.

[5]  R. Sacco,et al.  Clinical, histological and histomorphometric evaluation of the healing of mandibular ramus bone block grafts for alveolar ridge augmentation before implant placement. , 2010, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[6]  D. Buser,et al.  Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. , 2006, Clinical oral implants research.

[7]  K. Schlegel,et al.  Stability of autogenous bone grafts after sinus lift procedures: a comparative study between anterior and posterior aspects of the iliac crest and an intraoral donor site. , 2005, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[8]  Stefano Gracis,et al.  Influence of the 3-D bone-to-implant relationship on esthetics. , 2005, The International journal of periodontics & restorative dentistry.

[9]  C. Maiorana,et al.  Reduction of autogenous bone graft resorption by means of bio-oss coverage: a prospective study. , 2005, The International journal of periodontics & restorative dentistry.

[10]  Simone Windisch,et al.  Immediate occlusal loading of Brånemark System TiUnite implants placed predominantly in soft bone: 4-year results of a prospective clinical study. , 2005, Clinical implant dentistry and related research.

[11]  Jean-Pierre Bernard,et al.  Implant stability measurement of delayed and immediately loaded implants during healing. , 2004, Clinical oral implants research.

[12]  P. Proussaefs,et al.  Immediate loading of hydroxyapatite-coated implants in the maxillary premolar area: three-year results of a pilot study. , 2004, The Journal of prosthetic dentistry.

[13]  Kitichai Rungcharassaeng,et al.  Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. , 2003, The International journal of oral & maxillofacial implants.

[14]  J. Lindhe,et al.  Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial. An experiment in the dog. , 2002, Journal of clinical periodontology.

[15]  E. Nkenke,et al.  Morbidity of harvesting of retromolar bone grafts: a prospective study. , 2002, Clinical oral implants research.

[16]  H. Haanaes,et al.  Immediate loading of single-tooth ITI implants in the anterior maxilla: a prospective 5-year pilot study. , 2002, Clinical oral implants research.

[17]  D Buser,et al.  Evaluation of a prototype trilayer membrane (PTLM) for lateral ridge augmentation: an experimental study in the canine mandible. , 2002, International journal of oral and maxillofacial surgery.

[18]  P. Proussaefs,et al.  The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: a pilot study. , 2002, The International journal of oral & maxillofacial implants.

[19]  Luca Cordaro,et al.  Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. , 2002, Clinical oral implants research.

[20]  P. Missika,et al.  A prospective randomized study comparing two techniques of bone augmentation: onlay graft alone or associated with a membrane. , 2001, Clinical oral implants research.

[21]  J. Liu,et al.  Immediate provisional for single-tooth implant replacement with Brånemark system: preliminary report. , 2001, Clinical implant dentistry and related research.

[22]  R. Yukna,et al.  Collagen Membrane Resorption in Dogs: A Comparative Study , 2001, Implant dentistry.

[23]  M. Chiapasco,et al.  Clinical outcome of autogenous bone blocks or guided bone regeneration with e-PTFE membranes for the reconstruction of narrow edentulous ridges. , 1999, Clinical oral implants research.

[24]  Pikos Ma.  Alveolar ridge augmentation with ramus buccal shelf autografts and impacted third molar removal. , 1999 .

[25]  C. Misch.  Comparison of intraoral donor sites for onlay grafting prior to implant placement. , 1997, The International journal of oral & maxillofacial implants.

[26]  N. Hardt,et al.  The TIME technique: a new method for localized alveolar ridge augmentation prior to placement of dental implants. , 1996, The International journal of oral & maxillofacial implants.

[27]  D Buser,et al.  Lateral ridge augmentation using autografts and barrier membranes: a clinical study with 40 partially edentulous patients. , 1996, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[28]  S. Sindet‐Pedersen,et al.  Autogenous mandibular bone grafts and osseointegrated implants for reconstruction of the severely atrophied maxilla: a preliminary report. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.