Long-term stability of atrophic ridges reconstructed with hydroxylapatite: a prospective study.
OBJECTIVE
This article reports the results of an investigation of the long-term efficacy and stability of reconstructive surgery of atrophic ridges using dense hydroxylapatite (HA).


METHODS
Subperiosteal HA was used as a first stage of reconstruction in 678 ridges, 645 mandibular and 35 maxillary, followed after 4 to 5 weeks by a total lowering of the floor of the mouth, vestibuloplasty, and skin graft in the mandible: a same-stage submucous vestibuloplasty was done in the maxilla. Patients were followed for an average of 5.3 +/- 2.7 years by the same surgical and prosthodontic team. The presence of severe or moderate radiographic change was analyzed in relation to gender, age, severity of atrophy, postoperative complications, clinical changes, patient satisfaction, and type of HA particles used alone or with a binder.


RESULTS
Seventy-seven percent of cases had no observable radiographic changes, 13% had moderate changes, and 10% had severe changes, of which fewer than half also had severe clinical changes. Relationships were established between the presence of radiographic change and certain parameters, especially postoperative delay in healing, severe or moderate clinical changes, and type of HA particles used.


CONCLUSIONS
Hydroxylapatite, when used alone or with binding agents, and in association with basic techniques of reconstructive surgery and soft tissue handling, is a predictable and stable biomaterial for ridge reconstruction.
Mercier
P
P
Maxillary Atrophy Clinic St. Mary's Hospital, Montreal, Quebec, Canada.
Bellavance
F
F
Cholewa
J
J
Djokovic
S
S
D000367:Age Factors; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects / Q000379:methods*; D001284:Atrophy; D001672:Biocompatible Materials / Q000737:chemistry; D015921:Dental Implants; D017886:Durapatite / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D019736:Prostheses and Implants; D011859:Radiography; D012737:Sex Factors; D016038:Skin Transplantation; D014727:Vestibuloplasty; D014945:Wound Healing
D001672:Biocompatible Materials; D015921:Dental Implants; D017886:Durapatite