Implant-supported restoration of congenitally missing teeth using cancellous bone block-allografts.
OBJECTIVE
Patients with congenitally missing teeth may present with undeveloped alveolar bone morphology, making implant reconstruction a challenge. The aim of the present study was to evaluate the outcome of dental implants after ridge augmentation with cancellous freeze-dried block bone allografts in patients with congenitally missing teeth.


METHODS
Twelve patients with a mean age of 21 ± 4 years, were included. Congenitally missing teeth included maxillary lateral incisors, a maxillary canine, and mandibular central and lateral incisors. A bony deficiency of ≥3 mm horizontally and ≤3 mm vertically according to computerized tomography served as inclusion criteria. Twenty-one implants were inserted after a healing period of 6 months. Five out of 21 implants were immediately restored. Bone measurements were taken before bone augmentation, during implant placement, and at second-stage surgery.


RESULTS
Nineteen cancellous allogeneic bone-blocks were used. The mean follow-up time was 30 ± 16 months. Bone block and implant survival rates were 100% and 95.2%, respectively. Mean bone gain was statistically significant (P < .001): 5 ± 0.5 mm horizontally and 2 ± 0.5 mm vertically. All of the patients received a fixed implant-supported prosthesis. Soft tissue complications occurred in 4 patients (30%). Complications after cementation of the crowns were seen in 1 implant (4.8%). All implants remained clinically osseointegrated at the end of the follow-up examination. There was no crestal bone loss around the implants beyond the first implant thread.


CONCLUSIONS
Cancellous bone block-allografts can be used successfully for implant-supported restorations in patients with congenitally missing teeth.
Nissan
Joseph
J
Department of Oral Rehabilitation, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Mardinger
Ofer
O
Strauss
Morris
M
Peleg
Michael
M
Sacco
Roberto
R
Chaushu
Gavriel
G
D000293:Adolescent; D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000848:Anodontia / Q000628:therapy*; D016025:Bone Transplantation / Q000379:methods*; D002484:Cementation / Q000009:adverse effects; D002508:Cephalometry; D003442:Crowns; D003481:Cuspid / Q000002:abnormalities; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D005882:Gingival Diseases / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D057893:Immediate Dental Implant Loading; D007180:Incisor / Q000002:abnormalities; D008297:Male; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D016348:Osseointegration / Q000502:physiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D015921:Dental Implants