Implant reconstruction of the bone-grafted maxilla: review of the literature and presentation of 8 cases.
OBJECTIVE
This study prospectively investigates the long-term success of iliac crest bone grafting and the secondary placement of osseointegrated implants in reconstructing maxillae with severely reduced bone mass.


METHODS
Eight consecutive patients (7 women, 1 man), aged 18 to 69 (mean, 49.6), were treated by augmentation of their maxillae with corticocancellous autogenous iliac bone blocks. Forty-one Branemark implants of 7 to 15 mm in length and 3.75 mm in diameter were placed after a minimum delay of 6 months. Bone healing, maintenance of bone height, and implant stability were measured by clinical examination and radiographic control.


RESULTS
One patient was lost to follow-up at 24 months after delivery of the prosthesis and one was lost at 75 months. The average duration of follow-up after loading of the implants was 90.5 months, and the longest was 154 months. Thirty-four of 41 (83%) of the implants survived to the end of the observation period. Four of 6 implants that failed were 7 mm in length and the other 2 were 10 mm in length. One 10-mm implant was "slept" because of poor positioning. All prostheses survived. There was one significant gingival infection that resulted in loss of 1.5 mm of bone after which the implant remained stable. None of the other implants were associated with crestal bone loss of more than 0.5 mm for the duration of this study.


CONCLUSIONS
Delayed placement of osseointegrated implants in maxillae augmented by iliac bone grafts is predictable and successful in the long term.
OMS Service, Sinai Grace Hospital, Detroit Medical Center, Detroit, MI, USA. lclayman@hotmail.com
Lewis
L
Clayman
D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008439:Maxillary Diseases / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection; D016896:Treatment Outcome
D015921:Dental Implants