title: Calvarial Bone Grafting for Three-Dimensional Reconstruction of Severe Maxillary Defects: A Case Series.
abstract: OBJECTIVE
  To evaluate the efficacy, associated morbidity, and results of a three-dimensional reconstruction technique for repairing severe defects of the maxilla using a calvarial autogenous bone graft and a soft tissue double-layered surgical approach in preparation for placing dental implants.
  
  
  METHODS
  Bone defects of the maxilla consecutively reconstructed with calvarial autologous graft in the authors' institution were retrospectively evaluated. Patients with combined maxilla alveolar ridge defects with a width less than 4 mm and a height less than 7 mm (to the level of the maxillary sinus or the nostril), with at least three teeth involved, were included in the study. Calvarial bone blocks were sagittally sectioned in fine layers and fixed three-dimensionally in a boxlike structure with particulate bone inside. The purpose was to obtain an adequate amount of vertical and horizontal alveolar bone to enable restoration with dental implants at least 3.4 mm in diameter and 11 mm in length.
  
  
  RESULTS
  Eleven reconstructive procedures were performed in 10 patients. Bone graft integration was successful in all of them. No major complications were observed in the donor cranial site. A mean bone gain of 5.04 mm (range, 3.4 to 7.8 mm) in height was obtained (standard deviation [SD], 1.69). The implant surgery was performed between the 15th and 19th weeks. A total of 28 implants were placed, and the mean follow-up time was 45 months (range, 23 to 65 months; SD, 12). The mean graft vertical resorption was 0.78 mm (range, 0.50-1.50 mm; SD, 0.00) 41 months after implant fixation.
  
  
  CONCLUSIONS
  Three-dimensional reconstruction technique using calvarial bone grafts to restore severe segmental or crestal bone defects in the maxilla is an effective and predictable procedure that can increase the horizontal and vertical bone volume in preparation for the successful placement of dental implants.
authors.forename: Andres
authors.initials: A
authors.lastname: Restoy-Lozano
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Dominguez-Mompell
authors.forename: Pedro
authors.initials: P
authors.lastname: Infante-Cossio
authors.forename: Juan
authors.initials: J
authors.lastname: Lara-Chao
authors.forename: Victor
authors.initials: V
authors.lastname: Lopez-Pizarro
mesh_terms: D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000543:Alveoloplasty / Q000379:methods; D001284:Atrophy; D064592:Autografts / Q000637:transplantation*; D001672:Biocompatible Materials / Q000737:chemistry; D001843:Bone Cements / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D002130:Calcium Phosphates / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010294:Parietal Bone / Q000601:surgery; D012189:Retrospective Studies; D013526:Surgical Mesh; D020858:Tissue and Organ Harvesting / Q000379:methods; D014025:Titanium / Q000737:chemistry; D060053:Transplant Donor Site / Q000601:surgery
chemical_list: D001672:Biocompatible Materials; D001843:Bone Cements; D002130:Calcium Phosphates; D015921:Dental Implants; C020243:calcium phosphate; D014025:Titanium