title: Oral implants in combination with bone grafts. A 3-year retrospective multicenter study using the Brånemark implant system.
abstract: A retrospective, multicenter, Scandinavian study of bone grafting of alveolar processes of severely atrophic jaws in combination with implant insertion was conducted with 150 patients. Five different grafting techniques were assessed: local or full onlay; inlay; combination of onlay/inlay grafts; and LeFort I osteotomies. The majority of the patients were treated using a one-stage approach (n = 125) and all had autogenous bone grafts. A total of 781 Brånemark implants were inserted, of which 624 were placed in bone grafts and alveolar bone. Twenty-five patients (17%) dropped out during the follow-up period of three years. Within the remaining patients, 77% of the inserted implants (n = 516) were still in function at the end of the follow-up period. A further ten implants were kept mucosa-covered, resulting in an overall implant survival rate of around 80%. Onlays, inlays and LeFort I osteotomies showed almost the same success rates (76-84%), whereas the onlay/inlay technique gave rise to less favourable results (60%). Most of the observed losses (n = 131) took place during healing and the first year of loading. More implants were lost when they were inserted simultaneously with the grafting (23%) than when they were placed in a second stage (10%). The latter technique was used mainly in combination with local onlay grafting (16/25). The failure percentage for implants inserted in non-grafted bone (11%) was lower than for those inserted in bone grafts and alveolar bone (25%). The surviving implants of treated and followed patients served, in 88% of the cases (n = 110), to support fixed bridges or overdentures, albeit, in some instances (n = 23), after additional implant placement. In only 15 patients was it necessary to fall back on conventional removable prostheses or fixed partial bridges.
authors.affiliation: The Brånemark Clinic, Public Dental Health and Faculty of Odontology, University of Göteborg, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Lekholm
authors.forename: K
authors.initials: K
authors.lastname: Wannfors
authors.forename: S
authors.initials: S
authors.lastname: Isaksson
authors.forename: B
authors.initials: B
authors.lastname: Adielsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001184:Articulation Disorders / Q000209:etiology; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D019340:Osteotomy, Le Fort; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants