title: Permucosal implants combined with iliac crest onlay grafts used in extreme atrophy of the mandible: long-term results of a prospective study.
abstract: Thirteen patients received an onlay bone-graft augmentation to their severely atrophic mandible in combination with simultaneous implant insertion. This treatment modality was studied in a long-term prospective clinical and radiographic study. A reproducible measurement method, consisting of oblique lateral cephalometric radiographs, in combination with an image analysis system, was used to accurately assess the graft resorption rate. On average, 51% (95% confidence interval 42-61%) of the grafted bone height remained after 10-11 years. Resorption of the graft occurred mainly during the first years and showed a marked degree of individual variance. In the following years, the resorption rate followed a predictable pattern in most of our patients. Ventral and dorsal sites exhibited a similar degree of resorption. Peri-implantitis occurred in nine patients. Ten muco-gingival surgical interventions were necessary in four of these nine patients. No implants were lost and 12 patients indicated that they were satisfied. It is concluded that the described surgical technique should be used on stringent indication only, and alternative techniques are discussed.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands. j.w.verhoeven@med.uu.nl
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Verhoeven
authors.forename: Marco Stephan
authors.initials: MS
authors.lastname: Cune
authors.forename: Jan
authors.initials: J
authors.lastname: Ruijter
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects / Q000379:methods*; D001862:Bone Resorption / Q000209:etiology*; D016025:Bone Transplantation / Q000009:adverse effects*; D002508:Cephalometry; D003758:Dental Implantation, Endosseous / Q000009:adverse effects* / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008875:Middle Aged; D010518:Periodontitis / Q000209:etiology; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012044:Regression Analysis; D014727:Vestibuloplasty
chemical_list: D015921:Dental Implants