One-step oral rehabilitation by means of implants' insertion, Le Fort I, grafts, and immediate loading.
OBJECTIVE
In the last decade, several investigators have reported that autologous and homologous fresh frozen bones are effective materials to restore alveolar ridges before insertion of dental implants. Recently, we have used femur homograft derived from living donors. Here, we reported a 1-step oral rehabilitation of the severely resorbed maxilla by means of implants' insertion, Le Fort I osteotomy for maxillary advancement, grafts, and immediate loading.


METHODS
Patients were treated with 1-step oral rehabilitation. Age, sex, implant length and diameter, tooth site, loading, and grafts were the investigated variables. Implant failure and peri-implant bone resorption were considered as predictors of clinical outcome. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome.


RESULTS
Eighty-four implants were inserted in 11 patients. Implants were inserted to replace 22 incisors, 21 cuspids, 20 premolars, and 21 molars. The mean follow-up was 17 months. Two of 84 implants were lost (ie, survival rate = 97.6%), and no differences were detected among the studied variables. By using the 82 fixtures processed with Kaplan-Meier and Cox regression, only implant site has an impact on clinical outcome, and molars have a worse outcome than incisors.


CONCLUSIONS
One-step oral rehabilitation can be used in selected patients. It significantly shortened the time of rehabilitation without adverse effects. Femur homograft derived from living donors is a valuable material for grafting jaw: it is safer, cheap, and available in programmed amounts and avoids a second operation field.
Grecchi
Francesco
F
Maxillofacial Surgery, Orthopaedic Institute Galeazzi, Milan, Italy. crc@unife.it
Zollino
Ilaria
I
Parafioriti
Antonina
A
Mineo
Giuseppe
G
Pricolo
Alfonso
A
Carinci
Francesco
F
D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants / Q000009:adverse effects; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D005260:Female; D005269:Femur; D006801:Humans; D007180:Incisor; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D053208:Kaplan-Meier Estimate; D019520:Living Donors; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D008963:Molar; D019340:Osteotomy, Le Fort; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors
D015921:Dental Implants