Cancellous bone block allografts for the augmentation of the anterior atrophic maxilla.
BACKGROUND
Pre-implant augmentative surgery is a prerequisite in many cases in the anterior maxilla to achieve a stable, long-term esthetic final result.


OBJECTIVE
The aim of the present study was to evaluate the outcome of ridge augmentation with cancellous freeze-dried block bone allografts in the anterior atrophic maxilla followed by placement of dental implants.


METHODS
Thirty-one consecutive patients were included in the study. A bony deficiency of at least 3 mm horizontally and up to 3 mm vertically according to computerized tomography (CT) served as inclusion criteria. Sixty-three implants were inserted after a healing period of 6 months. Nineteen of sixty-three implants were immediately restored. Bone measurements were taken prior to bone augmentation, during implant placement, and at second-stage surgery.


RESULTS
Forty-six cancellous allogeneic bone blocks were used. The mean follow-up was 34 ± 16 months. Mean bone gain was 5 ± 0.5 mm horizontally, and 2 ± 0.5 mm vertically. Mean buccal bone resorption was 0.5 ± 0.5 mm at implant placement, and 0.2 ± 0.2 mm at second-stage surgery. Mean bone thickness buccal to the implant neck was 2.5 ± 0.5 mm at implant placement, and 2.3 ± 0.2 mm at second-stage surgery. There was no evidence of vertical bone loss between implant placement and second-stage surgery. Block and implant survival rates were 95.6 and 98%, respectively. All patients received a fixed implant-supported prosthesis.


CONCLUSIONS
Cancellous block allografts appear to hold promise for grafting the anterior atrophic maxilla.
Nissan
Joseph
J
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. nissandr@post.tau.ac.il
Mardinger
Ofer
O
Calderon
Shlomo
S
Romanos
George E
GE
Chaushu
Gavriel
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001857:Bone Matrix / Q000637:transplantation; D016025:Bone Transplantation / Q000379:methods*; D003094:Collagen / Q000627:therapeutic use; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D006085:Graft Survival; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D016348:Osseointegration / Q000502:physiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
C106416:Bio-Gide; C077540:Bio-Oss; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen