title: Reconstruction of the severely atrophic edentulous maxillae with calvarial bone grafts.
abstract: OBJECTIVE
  Treatment of the severely atrophic maxilla with dental implants is challenging due to the insufficient horizontal and vertical bone volume and centripetal resorption pattern of the maxilla. Bone-augmentation procedures are often necessary prior to implant placement. The objective of this study was to assess the suitability of using calvarial bone grafts to enable implant placement in severely atrophic maxillae.
  
  
  METHODS
  Seventeen patients with severe atrophic edentulous maxillae were reconstructed with autogenous calvarial bone grafts. After a 4-month healing period, the patients received a total of 134 dental implants, which were left to heal in submerged positions for 3 months before prosthetic rehabilitation was performed. Patients were followed clinically and radiographically for an average observation period of 53.94 months.
  
  
  RESULTS
  At the intraoral recipient sites, two infections developed, causing partial loss of the respective bone grafts. Implant placement, however, was possible at all sites. No donor-site complications occurred. Two of 134 implants were lost in two patients prior to prosthetic loading. The implant survival rate was 98.51%. The implant success rate was 87.6%, and a mean marginal bone loss of 0.62 mm (SD 0.77 mm) was documented.
  
  
  CONCLUSIONS
  Patients with severe bone atrophy of the edentulous maxilla can be successfully reconstructed with calvarial bone grafts and dental implants and show a stable clinical and radiographic situation after a mean observation period of 53 months.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Mertens
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Kolja
authors.initials: K
authors.lastname: Freier
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Engel
authors.affiliation: Institute of Medical Biometry and Informatics, University Heidelberg, Heidelberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Krisam
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Freudlsperger
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery*; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012886:Skull / Q000637:transplantation
keywords: block grafting; calvarial bone grafting; edentulous maxillae; horizontal bone grafting; severe bone atrophy; vertical bone grafting