title: The combined use of two endosteal implants and iliac crest onlay grafts in the severely atrophic mandible by a modified surgical approach.
abstract: Seventeen patients, who received an iliac crest onlay bone graft augmentation to their severely atrophic mandible with simultaneous placement of two endosteal implants by a modified surgical approach, were studied retrospectively. Follow-up ranged from 0.5 to 7.9 years after implant loading with an average follow-up of 4.3 years. Frequency of wound dehiscences and other postoperative complications, the extend of resorption of the initial graft, and the implant success rate were assessed. Two patients, who had a previous history of preprosthetic and implantological procedures at the surgical site, developed a serious wound dehiscence with loss of two implants in one patient and need for antibiotic treatment and sequestrectomy in the other patient. One implant was lost in two other patients with a negative surgical history, resulting in an implant success rate of 88.2%. The average resorption at the last follow up visit was 15% of the initial graft. Damage of the mental nerve was seen in 14.7% of nerves. Our preliminary data indicate that the procedure presented provides a reliable and predictable method for the construction of an implant-bearing overdenture in patients with a severely atrophic mandible. This one-step procedure can not be recommended for patients with a history of surgery in the anterior mandible.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: E H
authors.initials: EH
authors.lastname: van der Meij
authors.forename: J
authors.initials: J
authors.lastname: Blankestijn
authors.forename: R M
authors.initials: RM
authors.lastname: Berns
authors.forename: R J
authors.initials: RJ
authors.lastname: Bun
authors.forename: A
authors.initials: A
authors.lastname: Jovanovic
authors.forename: J M
authors.initials: JM
authors.lastname: Onland
authors.forename: J
authors.initials: J
authors.lastname: Schoen
mesh_terms: D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods; D001284:Atrophy; D001862:Bone Resorption / Q000209:etiology; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D002680:Chin / Q000294:innervation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019232:Dental Restoration Failure; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants